文档介绍：New advances in COPD between 2007 and 2008 (starting from 2006)
Paul Jones MD, PhD
Professor of Respiratory Medicine
St e’s, University of London
COPD staging (FEV1/FVC < )
Stage 1
Mild
FEV1 ≥ 80% predicted
Stage 2
Moderate
FEV1 50 – 79%
Stage 3
Severe
FEV1 30 – 49%
Stage 4
Very Severe
FEV1 <30% or with respiratory failure
GOLD treatment guidelines 2007
GOLD 2006 treatment aims
Relieve symptoms
Improve exercise tolerance
Improve health status
Prevent and treat exacerbations
Prevent disease progression
Reduce mortality
Minimize side-effects
Inflammation in COPD
CD8+ T-Lymphocytes
* Adjusted for multiplicity (p = unadjusted)
Placebo (n = 68)
Seretide (n = 55)
0
40
80
120
160
200
240
280
320
Median cells/mm2
Baseline
Week 12
Baseline
Week 12
p=*
Barnes et al M 2006; 173: 736
TORCH: Study Design
SFC 500/50 bd
FP 500 bd
Salmeterol 50 bd
Placebo
Duration = 3 years
1,533
1,534
1,524
1,521
6112 patients
2 week run-in
ITT population
(any PRN or regular short-acting bronchodliator and/or theophyline)
Regions
* Australia, New Zealand, Argentina, Brazil, Chile, Mexico, South Africa & Canada
Randomised
N=6184
USA
1401 (23%)
Asia Pacific
(12%)
(China 244 patients)
Eastern Europe
1179 (19%)
Western Europe
1911 (31%)
Other*
935 (15%)