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Canadians with COPD live longer on twice-a day beta agonist drugs than on once-a-day anticholinergics
Canadian Press
TORONTO — Patients with emphysema or chronic bronchitis had a lower death rate taking one class of COPD medication than another in a five-year study period, Ontario health administrative data reveals.
Chronic obstructive pulmonary disease, or COPD, affects an estimated 12 to 20 per cent of the adult population, and is the fourth most common cause of death in Canada.
Although it’s a common disease, it doesn’t get the recognition it needs, partly because it’s associated with smoking, said researcher Dr. Andrea Gershon of the Institute for Clinical Evaluative Sciences in Toronto.
However, anywhere from 15 to 50 per cent of sufferers were never smokers, she noted, and other risk factors include occupational exposures and second-hand smoke.
COPD is a huge burden on the health-care system and contributes to long wait times in emergency departments, Gershon said.
Her team examined records of more than 46,000 patients aged 66 years or older who were diagnosed with COPD. The patients were newly prescribed either an inhaled, long-acting beta-agonist like salmeterol and fomerterol or an anticholinergic like tiotropium between 2003 and 2007. Patients were followed for up to 5 1/2 years to compare survival rates.
The drugs help to widen the various “tubes” that make up the airway so that patients can breathe easier and air can flow better, Gershon said.
“People who were on the beta-agonists had a higher survival than those who were on the anticholinergics, so the people on the long-acting anticholinergics were … more likely to die sooner than those on the beta-agonists,” Gershon, a respirologist, said in an interview.
