Friday, September 26, 2008

Spirivia and Atrovent Slammed by JAMA

So says Medline Plus. You can access the JAMA abstract here.

The drugs Spirivia and Atrovent are prescribed for chronic obstructive pulmonary disease (COPD), and according to a recent report, each is associated with an increased risk of heart attack, stroke and other cardiovascular problems.

Spiriva and Atrovent are the most commonly prescribed once a day drug for treatment for COPD.

Chronic obstructive pulmonary disease (COPD) is a lung disease in which the lungs are damaged, making it hard to breathe. In COPD, the airways—the tubes that carry air in and out of your lungs—are partly obstructed, making it difficult to get air in and out.

Cigarette smoking is the most common cause of COPD. Most people with COPD are smokers or former smokers. Breathing in other kinds of lung irritants, like pollution, dust, or chemicals, over a long period of time may also cause or contribute to COPD.

The airways branch out like an upside-down tree, and at the end of each branch are many small, balloon-like air sacs called alveoli (al-VEE-uhl-EYE). In healthy people, each airway is clear and open. The air sacs are small and dainty, and both the airways and air sacs are elastic and springy. When you breathe in, each air sac fills up with air like a small balloon; when you breathe out, the balloon deflates and the air goes out. (See the How the Lungs Work section for details.) In COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out because:

* The airways and air sacs lose their elasticity (like an old rubber band).
* The walls between many of the air sacs are destroyed.
* The walls of the airways become thick and inflamed (swollen).
* Cells in the airways make more mucus (sputum) than usual, which tends to clog the airways.


There was a 58 percent increased risk of cardiac death, heart attack or stroke in people taking these drugs according to Dr. Sonal Singh, assistant professor of internal medicine at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. Singh was lead author of a paper published in the Sept. 24 issue of the Journal of the American Medical Association.

Medline Plus link is here.