New research out of Wake Forest University School of Medicine shows that use of the most commonly prescribed once-a-day treatment for chronic obstructive pulmonary disease (COPD) for longer than one month increases the risk of cardiovascular death, heart attack or stroke by more than 50 percent.
Researchers Sonal Singh, M.D., M.P.H., and Curt Furberg, M.D., Ph.D., of Wake Forest, along with Yoon K. Loke, at the University of East Anglia, UK, conducted a meta-analysis of 17 double-blind, randomized trials involving a total of 14,783 patients with COPD. Participants received treatment with inhaled anticholinergics, another form of active therapy or a placebo inhaler.
An analysis of the data showed that use of inhaled anticholinergics for more than one month significantly increased the risk of cardiovascular death, heart attacks, or strokes in COPD patients by 58 percent.
The results appear in the Sept. 24 issue of The Journal of the American Medical Association.
Inhaled anticholinergics are a class of drugs that relax the airways and prevent them from getting narrower, making it easier to breathe. They also protect the airways from spasms that can suddenly cause the airway to become narrower (bronchospasm).
The two most commonly used inhalers from the anticholinergic class are tiotropium bromide, marketed by Pfizer as Spiriva, and ipratropium bromide, made and marketed by Boehringer Ingelheim as Atrovent.
"Patients with COPD who use these inhalers are at a high risk of excess serious cardiovascular events due to their use," said Singh, an assistant professor of internal medicine. "In absolute terms, if these inhalers are used for one year, nearly one in 40 patients using these inhalers may develop cardiac death related to the drug, and nearly one in 174 patients may develop a heart attack associated with these inhalers."