Do Long-Acting Antimuscarinics Confer Cardiovascular Risk in COPD Patients?

Long-acting antimuscarinics (LAMA) are a first-line option for patients with chronic obstructive pulmonary disease (COPD) who are symptomatic or at risk for exacerbations; however, concern has been raised about long-term cardiovascular (CV) safety of LAMAs. Researchers examined the LAMA aclidinium (Pressair) and its effect on major adverse cardiovascular events (MACE), as well its efficacy in preventing moderate to severe COPD exacerbations.

In an industry-funded multicenter trial, 3589 patients with moderate to very severe COPD and either history of CV disease or two CV risk factors were randomized to aclidinium or placebo. About 60% of patients also were taking an inhaled steroid and a long-acting β-agonist. During 3 years, MACE rates were…