0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

Double-edged Sword?  Long-Acting Bronchodilators in Chronic Obstructive Pulmonary Disease

Prescott G. Woodruff, MD, MPH1
[+] Author Affiliations
1Cardiovascular Research Institute and Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of California, San Francisco
JAMA Intern Med. 2013;173(13):1184-1185. doi:10.1001/jamainternmed.2013.1201.
Text Size: A A A
Published online

Extract

No pharmacotherapy has been shown to meaningfully alter the rate of progression of chronic obstructive pulmonary disease (COPD). However, inhaled long-acting bronchodilators are mainstays of treatment in moderate to severe COPD because they improve lung function, dyspnea, rate of exacerbations, and quality of life.

Nonetheless, their use has been clouded by concerns regarding the cardiovascular risks of these medications. Gershon et al1 address this controversy using a case-control analysis nested in a retrospective cohort. Cases and controls were selected from 191 005 subjects 66 years or older who met a validated case definition of COPD. Cases were subjects newly prescribed long-acting inhaled β-agonists (LABAs) and muscarinic antagonists (LAMAs; termed long-actinganticholinergics by Gershon et al), and controls were matched for prognostic factors. Overall, 28.0% of subjects had a primary outcome event, defined as an emergency department visit or a hospitalization for a cardiovascular event. Newly prescribed LABAs and LAMAs were associated with increased risk of a cardiovascular event, but no difference in risk between the 2 medications was found. The authors recommend close monitoring of patients with COPD requiring long-acting bronchodilators regardless of drug class.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 2

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();