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Chronic obstructive pulmonary disease (COPD) is a common disease in industrialised countries and responsible for a considerable morbidity and mortality. Cigarette smoking is the most important aetiological factor. The EUROSCOP trial aims at investigating the hypothesis that airway inflammation plays an important pathogenic role in the development of chronic obstructive airway disease in smokers. In cigarette smokers with poorly reversible airflow obstruction, the effect over 3 yrs of an inhaled glucocorticosteroid, budesonide 400 micrograms b.i.d., on the decline of lung function, measured as postbronchodilator forced expiratory volume in one second (FEV1), will be compared with that of placebo. The trial has been designed to detect a difference in yearly decline of at least 30 ml.year-1. The study is a parallel group, randomised, double-blind, multicentre study. Patients will be recruited from 47 centres in 12 countries in Europe. It will start with a run-in consisting of two 3 month periods. During the first 3 months, the patients will be offered a smoking cessation programme. All patients who have not stopped smoking during this period will enter the second half of the run-in where compliance with the dosage regimen will be tested. After these two periods, patients will be randomised to receive either inhaled budesonide, 400 micrograms b.i.d., or placebo for a period of 3 yrs.

To study the cardioselectivity of xamoterol, eight asthmatic patients took part in a randomised, double-blind, cross-over study, in which xamoterol or saline were infused, followed by four increasing doses of terbutaline i.v. Circulatory studies showed a significant increase of systolic blood pressure after xamoterol 0.1 mg/kg compared to saline (P less than 0.05), and heart rate tended to increase. Diastolic blood pressure did not show any significant changes after the different treatments. Skeletal muscle tremor measurements with terbutaline stimulation did not show any differences after pre-treatment with either xamoterol or saline. Mean values of FEV1 did not reveal any significant difference before or after terbutaline stimulation between xamoterol and saline pre-treatments. However, in one patient, FEV decreased 60% after xamoterol, an effect which was reversed by terbutaline. Xamoterol did not have any effect on beta-adrenoceptor mediated skeletal muscle tremor and no significant effect on beta-adrenoceptor mediated bronchodilation in doses which gave a significant increase of systolic blood pressure. Thus, xamoterol was shown to be a selective beta 1-adrenoceptor agonist in man.