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Combo Treatment Works Best for COPD

Only Small Benefit Seen With Chronic Obstructive Pulmonary Disease Treatment

Survival Advantage Probably Small

Calverley says the high dropout rate in the untreated (placebo) patients -- 44% compared with 34% of the Advair-treated patients -- could help explain the failure to show a clear survival advantage in patients with the combination treatment.

But pulmonary disease expert Klaus F. Rabe, MD, PhD, tells WebMD the new findings suggest that if a survival advantage exists, it is probably a small one.

Rabe, a professor of medicine at Leiden University Medical Center in the Netherlands, is chairman of the science committee of the Global Initiative for Obstructive Lung Disease.

“The hope had been that this would be a wonder drug that would stop people from dying of this disease, but that does not appear to be the case,” he says.

In an editorial accompanying the study, Rabe concludes that COPD patients should not be treated with inhaled corticosteroids alone.

“Combination therapy, as compared with monotherapy with long-acting beta-agonists or inhaled corticosteroids, offers statistically significant advantages for health status, frequency of exacerbations, use of oral steroids, and -- probably most important clinically -- protection against a decline in lung function,” he wrote.

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