Navigation Links
New therapy reduces mortality in patients with severe COPD
Date:12/28/2007

Patients with severe COPD may benefit more from therapy that combines salmeterol and fluticasone [SFC] than treatment with tiotropium, according to results from a long-term, multi-center study, Investigating New Standards for Prophylaxis in Reducing Exacerbations (INSPIRE) that directly compared the two therapies.

Although we found no difference in the overall rate of exacerbations between treatment groups, SFC treatment was associated with better health status, fewer patient withdrawals, and a lower mortality rate than occurred during tiotropium therapy, said lead author if the study, Jadwiga Wedzicha, M.D., of the Royal Free & University College Medical School in London

This was the first large-scale trial to directly compare the two different treatment approaches. The results appeared in the first issue for January of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

The researchers recruited 1,323 patients with severe COPD and randomized them to receive one of two treatmentseither SFC or tiotropiumfor two years. They analyzed number and type of exacerbations, health status as measured by the St. Georges Respiratory Questionnaire (SGRQ), lung function (post-dose forced expiratory volume in one second) and study withdrawal rate. The study was double-blinded and double-dummy controlled, and all patients underwent identical intensification of treatment before beginning the trial to standardize their clinical conditions.

While exacerbation rates between the two treatment groups were statistically indistinguishable, there were differences in the treatment that the exacerbations required. Oral corticosteroids were used more often to treat the tiotropium group, whereas patients on SFC required antibiotics more frequently.

This finding provides indirect evidence that these treatments affect apparently similar patients in different ways that affect clinical judgment, wrote Dr. Wedzicha in the article. This difference warrants further study to determine the factors that affect therapeutic choice.

There was also a small but statistically significant improvement in the SGRQ scores for patients on SFC. While this difference did not reach the standard of clinical significance, it did indicate that overall, SFC patients experienced a slightly higher overall quality of life and a post-hoc analysis revealed that more patients on SFC had a clinically significant improvement in health status than those on tiotropium therapy

Most strikingly, mortality was significantly lower in the SFC group during the study period, even though the trial was not powered to detect such a difference. There was more than a 50 percent reduction in the risk of on-therapy all-cause death at any time during the study period for the SFC patients. Patients undergoing SFC treatment were also significantly less likely to withdraw from the trial than others.

Our study raises several important questions, noted Dr. Wedzicha. Why is there a difference between treatments" What is the biological basis of the differential effect on exacerbations, and is it related to the difference in mortality between the two treatments"

Despite no difference in the overall rate of exacerbations between treatment groups, SFC treatment was associated with better health status, fewer patient withdrawals, and a lower mortality rate than occurred during tiotropium therapy and this may have important implications for the clinical management of COPD.


'/>"/>

Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

Related medicine news :

1. Vision restoration therapy shown to improve brain activity in brain injured patients
2. HIV therapy in pregnancy-data support WHO recommendations
3. Family-based treatment more effective than supportive psychotherapy in treating bulimia
4. Trial to Test Gene Therapy for Angina in Women
5. One of the Largest Post-WHI Physician Surveys Shows More Education is Needed: Patient Misinformation About Hormone Therapy Remains High
6. Aromatherapy Gift Line Sheds Humorous Light on Modern Therapy
7. Chemotherapy may be culprit for fatigue in breast cancer survivors
8. Atlanta Falcons Physical Therapy Centers Set to Launch This Fall
9. New Drug No Substitute for Standard Blood-Clot Therapy
10. Stem Cell Therapy Disappoints Against Rare Kidney Ailment
11. Nucletron Announces Management Buy-Out to More Effectively Meet the Demands of Its Customers and the Radiation Therapy Community
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/3/2016)... FL (PRWEB) , ... May 03, 2016 , ... Branches, ... both its Grow & Climb children and youth programs in South Miami. Macy’s is ... years. , The Grow Program provides afterschool tutoring, mentoring, enrichment and academic support ...
(Date:5/3/2016)... ... 03, 2016 , ... The new web-based solution HIPAA ... practices, to better grasp and implement HIPAA’s privacy, security, and data breach requirements. ... well-defined, expert-created path to compliance. HIPAA Institute has positioned itself to be an ...
(Date:5/2/2016)... , ... May 02, 2016 , ... It has just ... the keynote speaker for five events throughout the month of May. , Uldrich is ... of national news outlets. He also frequently appears on the Science Channel’s FutureScape and ...
(Date:5/2/2016)... ... May 02, 2016 , ... Pets bring laughter, joy and love into ... owners celebrate National Pet Week, which falls on the first full week of May. ... cherish the human-animal bond and recognize responsible pet ownership. Pet owners can live out ...
(Date:5/2/2016)... ... May 02, 2016 , ... “Engineering Bubbles,” an oil painting submitted by ... Art Forum held recently at the Annual Meeting in Los Angeles. The first annual ... members and Annual Meeting attendees. , “Through art I hope to educate ...
Breaking Medicine News(10 mins):
(Date:4/28/2016)... Treato , the single ... today that it has been named a Cool Vendor ... Life Sciences, 2016, Stephen Davies , ... on life-science- oriented analytics, algorithms and smart machine technology ... confirm medication ingestion, and analyze unstructured information.   ...
(Date:4/28/2016)... 2016 Dr. Vivek Ahuja , ... Ste phen Schmidt ... provider of cloud-based software solutions for life sciences, today announced key ... a wealth of insight to a growing business.  This will bolster ... George Phillips joined ArisGlobal in the position of Vice ...
(Date:4/28/2016)...   Acsis , a leading provider of supply ... research and advisory firm IDC has named it a ... Pharmaceutical Track and Trace Software 2016 Vendor Assessment (doc ... of the capabilities and business strategies of 10 vendors ... Logo - http://photos.prnewswire.com/prnh/20160427/360791LOGO ...
Breaking Medicine Technology: