Some medications used in the treatment of newly diagnosed chronic obstructive pulmonary disease (COPD) may increase the risk of mortality, according to US researchers. Over 145 000 patients with newly diagnosed COPD were followed for up to 5 years, during which 32 130 died. A large control group of over 320 000 people were matched to the case patients on the basis of sex, age, and year of diagnosis. Measurements included all-cause mortality, respiratory and cardiovascular deaths, and exposure to COPD medications. Theophylline was associated with an increased risk of respiratory death and ipratropium with a greater risk of cardiovascular death. Inhaled corticosteroids were associated with a reduced risk of cardiovascular death. The researchers point out that a limitation of their study is that potential confounders such as smoking status and severity of COPD were unknown. They call for more research to determine whether the observed associations reflect causal relationships.
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