Article date: November 2009
By: Anthony Grosso, Ian Douglas, Aroon D. Hingorani, Raymond MacAllister, Richard Hubbard, Liam Smeeth, in Volume 68, Issue 5, pages 731-736
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT
AIMS
A recent communication from the United States Food and Drug Administration highlighted a possible increased risk of stroke associated with use of the relatively new inhaled anticholinergic drug, tiotropium bromide. Using the United Kingdom General Practice Research Database, we set out to assess the risk of stroke in individuals exposed to inhaled tiotropium bromide and two other inhaled treatments for airways disease.
METHODS
We used the self‐controlled case‐series that reduces confounding and minimizes the potential for biases in the quantification of risk estimates.
RESULTS
Of 1043 people with a diagnosis of incident stroke who had had at least one prescription for tiotropium bromide, 980 satisfied inclusion criteria. The age‐adjusted incidence rate ratio for all‐cause stoke in individuals exposed to tiotropium bromide (n= 980), ipratropium bromide (n= 4181) and fluticasone propionate/salmeterol xinafoate (n= 1000) was 1.1 [95% confidence interval (CI) 0.9, 1.3], 0.8 (95% CI 0.7, 0.9) and 1.0 (95% CI 0.9, 1.2), respectively.
CONCLUSIONS
We found no evidence of an increased risk of all‐cause stroke for individuals exposed to commonly prescribed inhaled treatments for chronic obstructive pulmonary disease.
DOI: 10.1111/j.1365-2125.2009.03517.x
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