Lessons from large clinical trials in managing COPD patients

Large, multicenter, randomized controlled trials in COPD have recently been completed. The largest of these studies are "Towards a Revolution in COPD Health" (TORCH) and "Understanding Potential Long-Term impacts on Function with Tiotropium" (UPLiFT®). These studies make considerable contributions to understanding the natural history of COPD. The objective of this article is to review the data from these different trials in order to find what can be learnt of 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 the progression of the disease.