Lung disease drugs more than double risk of heart attack and stroke

A review of 17 randomized trials of two drugs commonly used in the treatment of chronic obstructive pulmonary disorder (COPD) has found that they dramatically increase the risk of heart attack, stroke, and death from cardiovascular causes.

Sonal Singh, assistant professor of internal medicine at Wake Forest University School of Medicine, and colleagues found that people who took the inhaled anticholinergic drugs Spiriva or Atrovent for more than a month had a 58% increased risk of heart attack and stroke, or dying from a cardiovascular event. This study is not the first to find a link between inhaled anticholinergic drugs and cardiovascular problems. Just last week another study was published linking Atrovent to a 34% increased risk of cardiovascular death.

Boehringer Ingelheim and Pfizer, the manufacturers of Spiriva issued a news release strongly disagreeing with the results of Singh's study. They say the safety of Spiriva has been confirmed by 30 clinical trials, and that the majority of data used in Singh's study comes from a single study involving the use of Atrovent, not Spiriva.

Singh S, Loke YK, Furberg CD. Inhaled anticholinergics and risk of major adverse cardiovascular events in patients with chronic obstructive pulmonary disease. A systematic review and meta-analysis. JAMA. 2008;300:1439-1450.

Lee TA, Pickard S, Au DH, Bartle B, Weiss KB. Risk for Death Associated with Medications for Recently Diagnosed Chronic Obstructive Pulmonary Disease. Annals of Internal Medicine. 2008;149:380-390.

News release: Established safety profile of Spiriva® confirmed by 30 rigorously controlled clinical trials.  Boehringer Ingelheim and Pfizer Inc. September 23rd 2008.