FAQFAQ   SearchSearch   MemberlistMemberlist   UsergroupsUsergroups 
 ProfileProfile   PreferencesPreferences   Log in to check your private messagesLog in to check your private messages   Log inLog in 
Forum index » Medicine forums » cardiology
Common beta-agonist inhalers more than double death rate in COPD patients
Post new topic   Reply to topic Page 1 of 1 [3 Posts] View previous topic :: View next topic
Author Message
William Wagner
medicine forum Guru


Joined: 29 Apr 2005
Posts: 809

PostPosted: Sat Jul 08, 2006 10:25 am    Post subject: Common beta-agonist inhalers more than double death rate in COPD patients Reply with quote

http://www.news.cornell.edu/stories/June06/Salpeter.COPD.kr.html


http://www.news.cornell.edu/stories/June06/Salpeter.COPD.kr.html
 
 "A new analysis that compares two common inhalers for patients
suffering from chronic obstructive pulmonary disease (COPD) finds that
one reduces respiratory-related hospitalizations and respiratory deaths,
but the other -- which is prescribed in the majority of cases --
increases respiratory deaths."
 

  
 
June 29, 2006
Common beta-agonist inhalers more than double death rate in COPD
patients, Cornell and Stanford scientists assert
By Krishna Ramanujan

A new analysis that compares two common inhalers for patients suffering
from chronic obstructive pulmonary disease (COPD) finds that one reduces
respiratory-related hospitalizations and respiratory deaths, but the
other -- which is prescribed in the majority of cases -- increases
respiratory deaths.
The Cornell and Stanford universities' statistical analysis of 22 trials
with 15,276 participants found that common bronchodilators known as
anticholinergics (generically named tiotropium and ipratropium) reduced
severe respiratory events by 33 percent and respiratory-related deaths
by 73 percent, compared with a placebo.
However, the same meta-analysis (which combines the results of the
numerous studies) found that regularly inhaled beta-agonists
(metaproterenol [Alupent], formoterol [Foradil], salmeterol [Serevent,
Advair] and albuterol [Proventil, Ventolin, Volmax and others])
increased the risk of respiratory death more than twofold, compared with
a placebo.
Yet only 5 percent of all prescriptions for COPD are anticholinergics,
with beta-agonists dominating what doctors prescribe, the researchers
report.
The study, now online, will be published in an upcoming issue of the
Journal of General Internal Medicine.
COPD is a progressive lung disease characterized by difficulty
breathing, wheezing and a chronic cough. Complications include
bronchitis and pneumonia. It is often associated with smoking.
"When patients used the anticholinergics, they experienced fewer severe
exacerbations requiring hospitalizations and fewer respiratory deaths
than those taking only a placebo," said Edwin Salpeter, the J.G. White
Distinguished Professor of Physical Sciences Emeritus at Cornell, who
led the statistical analysis in the study. An eminent astrophysicist,
Salpeter has more recently focused his attention on medical statistics.
"With the beta-agonists, it's the other way around, where the number of
respiratory deaths increased when compared with those who took only the
placebo."
"These results suggest that anticholinergics should be the
bronchodilator of choice in COPD," said Shelley Salpeter, M.D., Edwin
Salpeter's daughter and the lead author. She is a clinical professor of
medicine at Stanford's School of Medicine and a physician at Santa Clara
Valley Medical Center in San Jose, Calif. "The long-term safety of
beta-agonists in patients with COPD should be addressed."
A recent meta-analysis by the Salpeters also revealed that beta-agonist
inhalers increased both hospitalizations and deaths in asthma sufferers
of all ages.
Previous studies have shown that patients with COPD build up tolerance
to beta-agonists' bronchodilator and bronchoprotective effects after
regular treatment compared with the first dose.
While beta-agonists may reduce symptoms through bronchodilation, the
researchers believe they also promote bronchial inflammation and
sensitivity by reducing bronchial protection without any warning of
increased symptoms, which can then lead to a life-threatening response.
In the trials that were analyzed, only two patients out of 4,036 who
took anticholinergics died of respiratory causes, while 12 of 3,845
participants in the placebo group died of respiratory ailments. When
patients inhaled beta-agonists, there were 21 respiratory deaths out of
1,320 patients and eight respiratory deaths out of 1,084 participants in
the placebo group.

Cornell News Service:
Krishna Ramanujan
(607) 255-3290
ksr32@cornell.edu
Media Contact:
Press Relations Office
(607) 254-6225
pressoffice@cornell.edu

--
S Jersey USA Zone 5 Shade
This article is posted under fair use rules in accordance with
Title 17 U.S.C. Section 107, and is strictly for the educational
and informative purposes. This material is distributed without profit.
Back to top
William Wagner
medicine forum Guru


Joined: 29 Apr 2005
Posts: 809

PostPosted: Sat Jul 08, 2006 10:52 am    Post subject: Re: Common beta-agonist inhalers more than double death rate in COPD patients Reply with quote

More on COPD and Statins of all things!

Bill

...............................



1: J Am Coll Cardiol. 2006 Jun 20;47(12):2554-60. Epub 2006 May 2.
Related Articles, Links
 
Reduction of morbidity and mortality by statins, angiotensin-converting
enzyme inhibitors, and angiotensin receptor blockers in patients with
chronic obstructive pulmonary disease.

Mancini GB, Etminan M, Zhang B, Levesque LE, FitzGerald JM, Brophy JM.

Division of Cardiology, Vancouver Hospital, Jack Bell Research Centre,
University of British Columbia, Vancouver, British Columbia, Canada.
mancini@interchange.ubc.ca

OBJECTIVES: The purpose of this study was to determine if statins
(hydroxymethylglutaryl CoA reductase inhibitors [HMG-CoA]),
angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor
blockers (ARBs) reduce cardiovascular (CV) events and pulmonary
morbidity in chronic obstructive pulmonary disease (COPD) patients.
BACKGROUND: Few current COPD therapies alter prognosis. Although
statins, ACE inhibitors, and ARBs improve outcomes in CV populations,
their benefits in COPD patients both with and without concomitant heart
disease has not previously been studied. METHODS: A time-matched nested
case-control study of two population-based retrospective cohorts was
undertaken: 1) COPD patients having undergone coronary revascularization
(high CV risk cohort); and 2) COPD patients without previous myocardial
infarction (MI) and newly treated with nonsteroidal anti-inflammatory
drugs (low CV risk cohort). Prespecified outcomes were COPD
hospitalization, MI, and total mortality. RESULTS: These drugs reduced
both CV and pulmonary outcomes, with the largest benefits occurring with
the combination of statins and either ACE inhibitors or ARBs. This
combination was associated with a reduction in COPD hospitalization
(risk ratio [RR] 0.66, 95% confidence interval [CI] 0.51 to 0.85) and
total mortality (RR 0.42, 95% CI 0.33 to 0.52) not only in the high CV
risk cohort but also in the low CV risk cohort (RR 0.77, 95% CI 0.67 to
0.87, and RR 0.36, 95% CI 0.28 to 0.45, respectively). The combination
also reduced MI in the high CV risk cohort (RR 0.39, 95% CI 0.31 to
0.49). Benefits were similar when steroid users were included.
CONCLUSIONS: These agents may have dual cardiopulmonary protective
properties, thereby substantially altering prognosis of patients with
COPD. These findings need confirmation in randomized clinical trials.

PMID: 16781387 [PubMed - in process]

--
S Jersey USA Zone 5 Shade
This article is posted under fair use rules in accordance with
Title 17 U.S.C. Section 107, and is strictly for the educational
and informative purposes. This material is distributed without profit.
Back to top
nospam7@heartmdphd.com
medicine forum Guru


Joined: 27 Dec 2005
Posts: 470

PostPosted: Sat Jul 08, 2006 5:33 pm    Post subject: Re: Common beta-agonist inhalers more than double death rate in COPD patients Reply with quote

William Wagner wrote:
Quote:
http://www.news.cornell.edu/stories/June06/Salpeter.COPD.kr.html

"A new analysis that compares two common inhalers for patients
suffering from chronic obstructive pulmonary disease (COPD) finds that
one reduces respiratory-related hospitalizations and respiratory deaths,
but the other -- which is prescribed in the majority of cases --
increases respiratory deaths."




June 29, 2006
Common beta-agonist inhalers more than double death rate in COPD
patients, Cornell and Stanford scientists assert
By Krishna Ramanujan

A new analysis that compares two common inhalers for patients suffering
from chronic obstructive pulmonary disease (COPD) finds that one reduces
respiratory-related hospitalizations and respiratory deaths, but the
other -- which is prescribed in the majority of cases -- increases
respiratory deaths.
The Cornell and Stanford universities' statistical analysis of 22 trials
with 15,276 participants found that common bronchodilators known as
anticholinergics (generically named tiotropium and ipratropium) reduced
severe respiratory events by 33 percent and respiratory-related deaths
by 73 percent, compared with a placebo.
However, the same meta-analysis (which combines the results of the
numerous studies) found that regularly inhaled beta-agonists
(metaproterenol [Alupent], formoterol [Foradil], salmeterol [Serevent,
Advair] and albuterol [Proventil, Ventolin, Volmax and others])
increased the risk of respiratory death more than twofold, compared with
a placebo.
Yet only 5 percent of all prescriptions for COPD are anticholinergics,
with beta-agonists dominating what doctors prescribe, the researchers
report.
The study, now online, will be published in an upcoming issue of the
Journal of General Internal Medicine.
COPD is a progressive lung disease characterized by difficulty
breathing, wheezing and a chronic cough. Complications include
bronchitis and pneumonia. It is often associated with smoking.
"When patients used the anticholinergics, they experienced fewer severe
exacerbations requiring hospitalizations and fewer respiratory deaths
than those taking only a placebo," said Edwin Salpeter, the J.G. White
Distinguished Professor of Physical Sciences Emeritus at Cornell, who
led the statistical analysis in the study. An eminent astrophysicist,
Salpeter has more recently focused his attention on medical statistics.
"With the beta-agonists, it's the other way around, where the number of
respiratory deaths increased when compared with those who took only the
placebo."
"These results suggest that anticholinergics should be the
bronchodilator of choice in COPD," said Shelley Salpeter, M.D., Edwin
Salpeter's daughter and the lead author. She is a clinical professor of
medicine at Stanford's School of Medicine and a physician at Santa Clara
Valley Medical Center in San Jose, Calif. "The long-term safety of
beta-agonists in patients with COPD should be addressed."
A recent meta-analysis by the Salpeters also revealed that beta-agonist
inhalers increased both hospitalizations and deaths in asthma sufferers
of all ages.
Previous studies have shown that patients with COPD build up tolerance
to beta-agonists' bronchodilator and bronchoprotective effects after
regular treatment compared with the first dose.
While beta-agonists may reduce symptoms through bronchodilation, the
researchers believe they also promote bronchial inflammation and
sensitivity by reducing bronchial protection without any warning of
increased symptoms, which can then lead to a life-threatening response.
In the trials that were analyzed, only two patients out of 4,036 who
took anticholinergics died of respiratory causes, while 12 of 3,845
participants in the placebo group died of respiratory ailments. When
patients inhaled beta-agonists, there were 21 respiratory deaths out of
1,320 patients and eight respiratory deaths out of 1,084 participants in
the placebo group.

Cornell News Service:
Krishna Ramanujan
(607) 255-3290
ksr32@cornell.edu
Media Contact:
Press Relations Office
(607) 254-6225
pressoffice@cornell.edu

--
S Jersey USA Zone 5 Shade
This article is posted under fair use rules in accordance with
Title 17 U.S.C. Section 107, and is strictly for the educational
and informative purposes. This material is distributed without profit.

Such "respiratory" deaths would have likely turned out to be
cardiovascular had a thorough post-mortem been performed.

Prayerfully in Christ's amazing love,

Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://tinyurl.com/frep8
Back to top
Google

Back to top
Display posts from previous:   
Post new topic   Reply to topic Page 1 of 1 [3 Posts] View previous topic :: View next topic
The time now is Sat Oct 01, 2011 2:22 pm | All times are GMT
Forum index » Medicine forums » cardiology
Jump to:  

Similar Topics
Topic Author Forum Replies Last Post
No new posts Diet supplements don't benefit cancer patients: journal J cancer 0 Wed Jul 19, 2006 10:01 am
No new posts investigative journalist seeks patients treated by Robert... nicodoesnotexist@yahoo.co dentistry 1 Mon Jul 17, 2006 2:16 am
No new posts Beta Thalassemia trait & H63D mutation in HFE & Hemachrom... George Lewycky laboratory 1 Fri Jul 14, 2006 3:28 am
No new posts Beta Thalassemia trait & H63D mutation in HFE & Hemachrom... George Lewycky patology 1 Fri Jul 14, 2006 2:56 am
No new posts Absorption rate of iron much higher than expected ironjustice@aol.com nutrition 0 Fri Jul 14, 2006 12:44 am

Copyright © 2004-2005 DeniX Solutions SRL
Other DeniX Solutions sites: email marketing campaigns , electronics forum, Science forum, Unix/Linux blog, Unix/Linux documentation, Unix/Linux forums


Powered by phpBB © 2001, 2005 phpBB Group
[ Time: 0.3721s ][ Queries: 16 (0.3346s) ][ GZIP on - Debug on ]