COPD Drugs Questioned for Increased Risk of Stroke, Heart Attack

Spiriva and Atrovent, two drugs widely prescribed in chronic obstructive pulmonary disease (COPD), were found to increase the risk of heart attack, stroke, and even death in a study made by researchers at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. The study was published this week in The Journal of the American Medical Association.

Spiriva is jointly marketed by Boehringer Ingelheim Pharmaceuticals Inc. and Pfizer Inc. The drug was approved by the Food and Drug Administration to relax muscles and open lung airways, symptoms that occur in COPD. Atrovent is used for the same condition, which kills more than 100,000 Americans annually. The main cause of the disease appears to be smoking.

Analyzing 17 studies involving almost 15,000 patients, researchers at Wake Forest University led by Dr. Sonal Singh, assistant professor of internal medicine, found a 58 percent increased risk of cardiovascular death, heart attack, or stroke in patients receiving Spiriva or Atrovent.

The FDA previously noted an increased risk of stroke citing an analysis of 13,500 patients. However, no specific reason was given for the risks found with the drug, but researchers believe that damaging proteins involved in inflammation are also involved in emphysema, chronic bronchitis, and heart diseases.

Spiriva’s makers were totally dissatisfied with the findings of the analysis saying their own analysis of 30 studies involving almost 20,000 patients found no such risk of heart attack, stroke or death among those taking the drug. “Patients and physicians can be confident that Spiriva is a safe and effective medication,” the companies’ statement read.

They also cited results from the four-year clinical trial known as Uplift involving nearly 6,000 patients, which showed no risk of heart disease or stroke.

“There was no evidence of an increased risk of death during the study,” lead investigator Marc De Cramer of the University Hospital Leuven, Belgium said.

Full results of the study will be presented at the annual meeting of the European Respiratory Society in Berlin on October 5.