Following our story last week on the possible deleterious effects of ipratropium from a study published in the Annals of Internal Medicine, a hot-off-the-presses JAMA meta-analysis concluded, "Inhaled anticholinergics are associated with a significantly increased risk of cardiovascular death, MI, or stroke among patients with COPD." Anticholinergic drugs relax the muscles around the airways to help relieve shortness of breath in patients with obstructive lung disease.
Specifically, the analysis looked at Spiriva and Atrovent, which Pfizer and Boehringer market. The reviewers performed a detailed screening of 103 articles and selected 17 trials with nearly 15,000 patients for analysis. The selected studies had follow-up periods that were anywhere from six weeks to five years.
Physicians prescribe the branded drugs, and their generic counterpart, ipratropium, to treat chronic obstructive pulmonary disease (COPD). In the U.S., COPD is a top-five cause of chronic disease and subsequent death.
The two companies most affected by the news responded quickly, saying they have analyzed 30 studies of nearly 20,000 patients and did not find an increased risk of the conditions in patients with chronic lung conditions. They are presenting data on their own trial, called UPLIFT, in Europe on October 5, 2008. Time will tell if what's good for the lung is bad for the heart.