Widely used inhaler could increase risks, study claims
Using a widely prescribed type of inhaler for a month or more could raise the risk of heart attack and death from cardiovascular disease for people with chronic lung disease, a study has found.
It’s the latest research to raise questions about the safety of anticholinergic inhalers such as Spiriva and Atrovent, which help people with chronic obstructive pulmonary disease, or COPD, to breathe more easily.
The odds of the inhalers causing problems were about one in 40 for cardiac death and one in 175 for heart attack.
But that needs to be weighed against significant quality-of-life improvements for patients who use these drugs, said Dr. Sonal Singh of Wake Forest University, lead author of the study published in the Journal of the American Medical Association.
The study analyzed the results of 17 previous clinical trials involving more than 14,000 patients with COPD, which includes chronic bronchitis and emphysema. None of the trials was designed to evaluate heart risks from inhalers. But the researchers found that long-term use of either the drug tiotropium, sold under the brand name Spiriva, or ipratropium, sold as Atrovent, raised the risk of cardiac death by 80 percent and of heart attack by 53 percent.
A study from Hines Veterans Affairs Hospital near Maywood, released earlier this month, had found that men who used ipratropium inhalers died more often from heart disease. The federal Food and Drug Administration had issued a notice in March of a possible increased risk of stroke with tiotropium
But the makers of Spiriva — Boehringer Ingelheim and Pfizer Inc., — said concerns about strokes and heart disease weren’t backed up by their own analysis of several long-term clinical trials. “We strongly disagree with the conclusion” of the JAMA study, a written statement from the companies said.
The new study is “concerning” but incomplete, said Dr. Ravi Kalhan, director of the COPD program at Northwestern University’s Feinberg School of Medicine, who was not involved in the research.
“Understanding the mechanisms behind this would certainly make the findings that much more believable,” Kalhan said.