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Long-acting bronchodilator initiation in COPD and the risk of adverse cardio-pulmonary events: A population-based comparative safety study.
CONCLUSION: COPD treatment initiation with tiotropium compared with LABA does not increase cardiovascular risk in the first year of treatment. The risk of pneumonia is higher with LABA, a likely effect of the inhaled corticosteroids present in many LABA inhalers used in real world clinical practice. PMID: 27554300 [PubMed - as supplied by publisher]
Source: Chest - August 19, 2016 Category: Respiratory Medicine Authors: Suissa S, Dellaniello S, Ernst P Tags: Chest Source Type: research

Concurrent use of long-acting bronchodilators in COPD and the risk of adverse cardiovascular events: A population-based study
In conclusion, the addition of a second long-acting bronchodilator in the real world setting treatment of COPD does not increase the risk of most cardiovascular events. The modest increase for heart failure may be due to residual confounding by indication and needs further investigation.
Source: European Respiratory Journal - November 7, 2016 Category: Respiratory Medicine Authors: Suissa, S., Dell'Aniello, S., Ernst, P. Tags: 5.1 Airway Pharmacology and Treatment Source Type: research

Long-acting bronchodilator initiation in COPD and cardio-pulmonary risks: A population-based comparative effectiveness study
Long-acting bronchodilators, including long-acting beta2-agonists (LABA) and the anticholinergic tiotropium, are recommended as initial maintenance treatment in COPD, though their risk on cardio-pulmonary events remains uncertain in real world settings. We assessed whether treatment initiation with tiotropium increases the risk of acute myocardial infarction (AMI), stroke, heart failure, arrhythmia and pneumonia, relative to a LABA.We identified all new users of a long-acting bronchodilator during 2002-2012, age 55 or older, from the United Kingdom's Clinical Practice Research Datalink. Each patient who initiated tiotropiu...
Source: European Respiratory Journal - November 7, 2016 Category: Respiratory Medicine Authors: Suissa, S., Dell'Aniello, S., Ernst, P. Tags: 5.1 Airway Pharmacology and Treatment Source Type: research

Concurrent use of long-acting bronchodilators in COPD and the risk of adverse cardiovascular events
The cardiovascular risk of concurrently using long-acting β2-agonists (LABAs) and anticholinergics (LAMAs) in COPD is uncertain. We assessed the comparative cardiovascular and cerebrovascular safety of adding a second long-acting bronchodilator in patients with COPD. We identified a cohort of COPD patients, new users of LABA or the LAMA tiotropium during 2002–2012, from the UK Clinical Practice Research Datalink. Using high-dimensional propensity scores, each patient adding a second bronchodilator was matched with a patient who remained on monotherapy. Patients were followed for 1 year for the occurrence of...
Source: European Respiratory Journal - May 23, 2017 Category: Respiratory Medicine Authors: Suissa, S., Dell'Aniello, S., Ernst, P. Tags: COPD and smoking Original Articles: COPD Source Type: research

Adding a Second Bronchodilator in COPD: A Meta-Analysis on the Risk of Specific Cardiovascular Serious Adverse Events of Tiotropium/Olodaterol Fixed-Dose Combination.
This study aimed to ascertain whether tiotropium/olodaterol (T/O) 5/5 μg fixed-dose combination (FDC) may modulate the risk of main cardiovascular outcomes in COPD patients enrolled in randomized controlled trials (RCTs). A meta-analysis (CRD42017070100) was performed by selecting RCTs reporting raw data from the ClinicalTrials.gov database concerning the impact of T/O 5/5 µg FDC vs. monocomponents on the occurrence of specific cardiovascular serious adverse events: arrhythmia, heart failure, myocardial infarction, and stroke. Data were reported as relative risk and 95% Confidence Interval, and the risk of publicatio...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - April 8, 2020 Category: Respiratory Medicine Tags: COPD Source Type: research

Overall and cardiovascular safety of aclidinium bromide in patients with COPD: Results of a pooled analysis
ConclusionsAclidinium has a good safety profile with no evidence of increased CV or cerebrovascular risk compared with placebo.
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Chapman, K. R., Beck, E., Alcaide, D., Garcia Gil, E. Tags: 5.1 Airway Pharmacology and Treatment Source Type: research

Prognostic factors of mortality and cardiovascular outcomes in the tiotropium safety and performance in respimat (TIOSPIR) trial
Conclusions: In TIOSPIR, prognostic factors for CV and all-cause mortality were similar, with greater risk for CV events in patients with CV medication or history (particularly IHD). High MMRC also particularly correlated with fatal CV events. Exacerbations were prognostic for both all-cause and CV death, but not for non-fatal CV events.Funded by Boehringer Ingelheim.
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Dahl, R., Dusser, D., Wise, R., Pledger, G., Anzueto, A., Mueller, A., Fowler, A., Calverley, P. Tags: 5.1 Airway Pharmacology and Treatment Source Type: research

Effects of acute dual bronchodilator treatment (tiotropium + olodaterol) on cardiopulmonary interactions in hyperinflated patients with COPD
We investigated whether lower operating lung volumes after inhaled bronchodilators are associated with beneficial effects on central (stroke volume and cardiac output) and peripheral (skeletal muscle blood flow) hemodynamic responses to exercise in COPD.In a double-blind, single-dose and placebo-controlled study, 20 patients with moderate-to-severe COPD (12 males, 69.4 ± 13.2yrs, FEV1= 47 ± 12%, and FRC=154 ± 31% pred) performed, at least 48 hrs apart, high intensity (75% peak work rate) exercise tests after tiotropium+olodaterol RespimatTM (TIO-OLO) or placebo. Impedance cardiography and near-infrared...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Berton, D. C., Marques, R. D., Palmer, B., Webb, K., ODonnell, D. E., Neder, J. A. Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research