Insights into interventions in managing COPD patients: lessons from the TORCH and UPLIFT^® studies

Marc Miravitlles¹, Antonio Anzueto²

¹Fundació Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain; ²Department of Pulmonary/Critical Care, The University of Texas Health Science Center at San Antonio and the South Texas Veterans Health Care System, San Antonio, Texas, USA

Abstract: Influencing the progression of COPD has long been an elusive goal of drug therapy. Directly or indirectly, this has again been investigated in two of the largest, long-term drug trials in COPD: Towards a Revolution in COPD Health (TORCH) and Understanding Potential Long-Term Impacts on Function with Tiotropium (UPLIFT^®). Neither trial achieved statistical significance in their respective primary outcomes; however, both make considerable contributions to understanding of how the progression of COPD may be influenced. The objective of this article is to review the data from these different trials with a view to what can be learnt about the management of COPD. The long-term improvements in lung function, health-related quality of life, and possibly survival from the use of long-acting bronchodilators in these trials suggest an influence on progression of the disease. With the more optimistic view of benefits from drug treatment of COPD that these trials provide, a review of prescribing practices is warranted.

Keywords: bronchodilators, FEV₁, fluticasone, inhaled corticosteroids, mortality, salmeterol, tiotropium