The drugs under scrutiny are tiotropium, sold as Spiriva Handihaler by Boehringer Ingelheim Pharmaceuticals, Inc., and ipratropium, sold by Boehringer under the brand name Atrovent. Also known as inhaled anticholinergics, the drugs work by relaxing the muscles around constricted airways and relieving symptoms such as shortness of breath.
Researchers at the Wake Forest University School of Medicine in Winston-Salem, N.C. conducted trials on more than 15,000 patients with COPD who took Spiriva or an older, generic drug called ipratropium. The results indicated that the use of two drugs Spiriva and Atrovent, for more than a month boosted the risk of heart attack, stroke, or dying of cardiovascular problems by 58 percent.
The scientists conducted 17 trials and found that long-term use (more than 30 days) of the two drugs increased the risk of a heart attack by 53 percent and the risk of cardiovascular death by 80 percent. One in 40 users can die from a heart condition and one in 174 to have a heart attack, say the researchers.
However, the scientists say it is not clear what caused the increased risks but they believe damaging proteins involved in inflammation are involved in both COPD and heart disease. The study appears in Wednesday's Journal of the American Medical Association.
