Could the JAMA article have been skewed partly because of the problems that are comorbidity to COPD?
COPD is frequently associated with multiple co‐morbidities. COPD is the 4th leading cause of death in the U.S., and the mortality data on COPD shows that many of those risks are cardiovascular. It may well be that those individuals with COPD have similar risk factors for cardiovascular disease, and could indeed have cardiovascular disease. That, however, does not answer all the questions. Therefore, if you do need to use a medicine and tiotropium is a very good medicine, you should use it with care and talk with your doctor. Q: Didn’t something similar happen recently regarding Spiriva®? A: Yes. In March of this year, Food and Drug Administration (FDA) communicated concerns over an imbalance of strokes presented in the preliminary data submitted by Boehringer‐Ingelheim Pharmaceuticals on Spiriva®. Safety investigations were conducted, but due to the lack of verifiable data, and with the pending results of the UPLIFT® study, the FDA decided to review the concern once the new study data
