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Two common COPD drugs have similar increased risk of cardiovascular events


Two commonly used inhaled medications for patients with chronic obstructive pulmonary disease (COPD) increase risk of heart attacks, heart failure and abnormal heart rhythms according to a study published in JAMA Internal Medicine by researchers at the Institute for Clinical Evaluative Sciences (ICES).

COPD is a largely preventable and manageable respiratory condition that affects more than 1 in 4 adults over the age of 35 during their lifetime, medications are a primary method to manage COPD.

The two medications, long-acting inhaled beta-agonists and anticholinergics are used almost interchangeable for moderate to severe COPD. To determine which was risker, researchers compared rates of emergency department visits and hospitalizations for cardiovascular events between groups of individuals taking each of these medications. Risk of events was compared after matching and adjusting for other prognostic factors.

"The risk of cardiovascular events appears the same for both medications, we did not find that one was safer or more risky than the other," says Dr. Andrea Gershon, lead author, ICES scientist and Respirologist and scientist at Sunnybrook Health Sciences Centre. “This information is important for COPD patients taking these medications to know.

In comparison to people not taking either medication, new users of inhaled, long-acting beta-agonists and anticholinergics were 14 to 31 per cent more likely to have a cardiovascular hospital or emergency department visit. Cardiovascular events appeared to be highest in the first 2 to 3 weeks after the medication was prescribed.

The researchers add that all COPD patients taking both these medications should be closely monitored for early symptoms and signs of cardiovascular problems.

Authors: Andrea Gershon, Ruth Croxford, Andrew Calzavara, Teresa To, Matthew B. Stanbrook, Ross Upshur, Thérèse A. Stukel.

The study “Cardiovascular safety of inhaled long-acting bronchodilators in people with COPD” was published today in JAMA Internal Medicine.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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