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Respir Med. 2003 Mar;97(3):264-72.

Is there any association between inhaled ipratropium and mortality in patients with COPD and asthma?

Author information

1
Department of Pulmonary Medicine, University Hospital of Copenhagen, Hvidovre, Denmark. ringbaek@dadlnet.dk

Abstract

BACKGROUND:

To determine whether ipratropium was associated with premature death in patients with asthma and chronic obstructive pulmonary disease (COPD).

METHODS:

A longitudinal cohort of 827 patients with COPD and 273 with asthma who were evaluated for compensation by two specialists in pulmonary medicine.

RESULTS:

By June 1999, 538 of the patients with COPD and 77 of those with asthma had died. Atthe consultation, 77% ofthe COPD patients and 8.1% of the asthmatic patients were treated with inhaled ipratropium. Ipratropium was associated with mortality risk ratio (RR) of 2.0 (95% confidence interval: 1.5-2.6) for COPD and 3.6 (1.8-7.1) for asthma patients. After adjustment for confounding factors [forced expiratory volume 1 s (FEV1), smoking habits, asthma medication, and presence of cor pulmonale] the RR for COPD was 1.6 (1.2-2.1) and for asthma 24 (1.2-5.0).

CONCLUSIONS:

The increased risk of premature death associated with ipratropium is of concern and necessitates further evaluation, e.g., in a randomised study.

Comment in

PMID:
12645834
[Indexed for MEDLINE]
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