Journal ArticleDOI
Effect of Pharmacotherapy on Rate of Decline of Lung Function in Chronic Obstructive Pulmonary Disease Results from the TORCH Study
Bartolome R. Celli,Nicola E. Thomas,Julie A. Anderson,Gary T. Ferguson,Christine Jenkins,Paul W. Jones,Jørgen Vestbo,Katharine Knobil,Julie C. Yates,Peter M.A. Calverley +9 more
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Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline of FEV(1) in patients with moderate-to-severe COPD, thus slowing disease progression.Abstract:
Rationale: Chronic obstructive pulmonary disease (COPD) is characterized by an accelerated decline in lung function. No drug has been shown conclusively to reduce this decline. Objectives :I n apost hoc analysis of the Toward a Revolution in COPD Health (TORCH) study, we investigated the effects of combined salmeterol 50 mg plus fluticasone propionate 500 mg, either component alone or placebo, on the rate of post-bronchodilator FEV1 decline in patients with moderate or severe COPD. Methods: A randomized, double-blind, placebo-controlled study was conducted from September 2000 to November 2005 in 42 countries. Of 6,112 patients from the efficacy population, 5,343 were included in this analysis. Measurements and Main Results: Spirometry was measured every 24 weeks for 3 years. There were 26,539 on-treatment observations. The adjusted rate of decline in FEV1 was 55 ml/year for placebo, 42 ml/year for salmeterol, 42 ml/year for fluticasone propionate, and 39 ml/year for salmeterol plus fluticasone propionate. Salmeterol plus fluticasone propionate reduced the rate of FEV1 decline by 16 ml/ year compared with placebo (95% confidence interval [CI], 7–25;P , 0.001). The difference was smaller for fluticasone propionate and salmeterol compared with placebo (13 ml/year; 95% CI, 5–22; P 5 0.003). Rates of decline were similar among the active treatment arms. FEV1 declined faster in current smokers and patients with a lower body mass index, and varied between world regions. Patients who exacerbated more frequently had a faster FEV1 decline. Conclusions: Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline of FEV1 in patients with moderate-to-severe COPD, thus slowing disease progression. Clinical trial (GSK Study Code SCO30003) registered with www. clinicaltrials.gov (NCT00268216).read more
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Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.
Jørgen Vestbo,Suzanne S. Hurd,Alvar Agusti,Paul W. Jones,Claus Vogelmeier,Antonio Anzueto,Peter J. Barnes,Leonardo M. Fabbri,Fernando J. Martinez,Masaharu Nishimura,Robert A. Stockley,Don D. Sin,Roberto Rodriguez-Roisin +12 more
TL;DR: It is recommended that spirometry is required for the clinical diagnosis of COPD to avoid misdiagnosis and to ensure proper evaluation of severity of airflow limitation.
Journal ArticleDOI
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary
Claus Vogelmeier,Gerard J. Criner,Fernando J. Martinez,Antonio Anzueto,Peter J. Barnes,Jean Bourbeau,Bartolome R. Celli,Rongchang Chen,Marc Decramer,Leonardo M. Fabbri,Peter Frith,David M.G. Halpin,M. Victorina López Varela,Masaharu Nishimura,Nicolas Roche,Roberto Rodriguez-Roisin,Don D. Sin,Dave Singh,Robert Stockley,Jørgen Vestbo,Jadwiga A. Wedzicha,Alvar Agusti +21 more
TL;DR: The assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation, and the concept of deescalation of therapy is introduced in the treatment assessment scheme.
Journal ArticleDOI
A 4-Year Trial of Tiotropium in chronic obstructive pulmonary disease
Donald P. Tashkin,Bartolome R. Celli,Stephen Senn,D Burkhart,Steven Kesten,Shailendra Menjoge,Marc Decramer +6 more
TL;DR: Therapy with tiotropium was associated with improvements in lung function, quality of life, and exacerbations during a 4-year period but did not significantly reduce the rate of decline in FEV(1).
Journal ArticleDOI
Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society
Amir Qaseem,Timothy J Wilt,Steven E. Weinberger,Nicola A. Hanania,Gerard J. Criner,Thys van der Molen,Darcy D. Marciniuk,Tom Denberg,Holger J. Schünemann,Wisia Wedzicha,Roderick MacDonald,Paul G. Shekelle +11 more
TL;DR: The value of history and physical examination for predicting airflow obstruction; the value of spirometry for screening or diagnosis of COPD; and COPD management strategies, specifically evaluation of various inhaled therapies, pulmonary rehabilitation programs, and supplemental oxygen therapy are addressed.
Journal ArticleDOI
Chronic obstructive pulmonary disease
TL;DR: The main cause is smoking tobacco, but other factors have been identified as mentioned in this paper, such as genetic determinants, lung growth, and environmental stimuli, which is further aggravated by exacerbations, particularly in patients with severe disease.
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Bartolome R. Celli,William MacNee,Alvar Agusti,Antonio Anzueto,B. Berg,A. S. Buist,Peter M.A. Calverley,Niels H. Chavannes,T. Dillard,Bonnie F. Fahy,Alan M. Fein,John E. Heffner,Suzanne C. Lareau,Paula Meek,Fernando J. Martinez,Walter T. McNicholas,Jean W M Muris,E. Austegard,Romain Pauwels,S. I. Rennard,Adriano G. Rossi,NM Siafakas,B. Tiep,Jørgen Vestbo,E. F. M. Wouters,Richard ZuWallack +25 more
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Journal ArticleDOI
The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index in Chronic Obstructive Pulmonary Disease
Bartolome R. Celli,Claudia Cote,Jose M. Marin,Ciro Casanova,Maria Montes de Oca,Reina A. Mendez,Victor Pinto Plata,Howard Cabral +7 more
TL;DR: The BODE index, a simple multidimensional grading system, is better than the FEV1 at predicting the risk of death from any cause and from respiratory causes among patients with COPD.