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TORCH
About the Trial
The Towards a Revolution in COPD Health trial randomized 6,112 COPD patients to salmeterol, fluticasone, the combination, or placebo. The combination reduced exacerbations and improved lung function and quality of life, and reduced all cause mortality by 17.5 percent, narrowly missing the predefined significance boundary, p equals 0.052, because of an interim analysis penalty. Pneumonia increased with inhaled steroids. TORCH established combined LABA ICS maintenance for moderate to severe COPD and fed a mortality debate that later trials such as SUMMIT and IMPACT revisited. The trial also standardized exacerbation as a COPD outcome and refined steroid risk awareness.
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