Inhaler can double COPD death rate

July 5, 2006 at 1:02 PM
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WASHINGTON, July 5 (UPI) -- While anticholinergic inhalers reduce COPD deaths by 73 percent, beta-agonist inhalers more than double it, a study said this week.

But it is the beta-agonist inhaler that is prescribed 95 percent of the time, said scientists at Cornell and Stanford universities in a study published in the current online issue of the Journal of General Internal Medicine.

The research team, led by Edwin Salpeter of Cornell, examined 22 trials that involved 15,276 participants. The researchers found that when patients with chronic obstructive pulmonary disease (COPD) used anticholinergic bronchodilators (tiotropium and ipratropium), severe respiratory events went down 33 percent and respiratory-related deaths dropped by 73 percent, compared to patients who received placebo.

In contrast, COPD patients using beta-agonist inhalers -- sold under the brand names Alupent, Foradil, Serevent, Advair -- or albuterol inhalers -- such as the branded products Proventil, Ventolin and Volmax -- had more than double the respiratory-related death rate vs. placebo.

In addition, hospitalizations and deaths increased in asthma patients of all ages who used beta-agonists.

The study authors said previous studies showed COPD becomes unresponsive to beta-agonists over time, and beta-agonists also promote bronchial inflammation and sensitivity, which may account for the results.

The team argued that anticholinergics should be the bronchodilator of choice in COPD and that long-term use of beta-agonists in COPD patients should be re-evaluated.

COPD is a progressive lung disease in which scarring from chronic bronchitis and the destruction of air sacs common in emphysema restrict air flow to the lungs.

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