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Cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists

PURPOSE: We examined the effect of olodaterol on the risk of myocardial ischaemia, cardiac arrhythmia, and all‐cause mortality compared with use of other long‐acting beta2‐agonists (LABAs). Channelling bias was also explored. METHODS: This Danish population‐based cohort study used data linked from r...

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Autores principales: Rebordosa, Cristina, Farkas, Dóra Körmendiné, Montonen, Jukka, Laugesen, Kristina, Voss, Florian, Aguado, Jaume, Bothner, Ulrich, Rothman, Kenneth J., Zint, Kristina, Mines, Daniel, Ehrenstein, Vera
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545725/
https://www.ncbi.nlm.nih.gov/pubmed/35320605
http://dx.doi.org/10.1002/pds.5432
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author Rebordosa, Cristina
Farkas, Dóra Körmendiné
Montonen, Jukka
Laugesen, Kristina
Voss, Florian
Aguado, Jaume
Bothner, Ulrich
Rothman, Kenneth J.
Zint, Kristina
Mines, Daniel
Ehrenstein, Vera
author_facet Rebordosa, Cristina
Farkas, Dóra Körmendiné
Montonen, Jukka
Laugesen, Kristina
Voss, Florian
Aguado, Jaume
Bothner, Ulrich
Rothman, Kenneth J.
Zint, Kristina
Mines, Daniel
Ehrenstein, Vera
author_sort Rebordosa, Cristina
collection PubMed
description PURPOSE: We examined the effect of olodaterol on the risk of myocardial ischaemia, cardiac arrhythmia, and all‐cause mortality compared with use of other long‐acting beta2‐agonists (LABAs). Channelling bias was also explored. METHODS: This Danish population‐based cohort study used data linked from registries of hospital diagnoses, outpatient dispensings, and deaths. It included patients (aged ≥40 years) with a diagnosis of chronic obstructive pulmonary disease (COPD) who initiated olodaterol or another LABA. Using matching and propensity score (PS) stratification, we calculated adjusted incidence rate ratios (IRRs) using Poisson regression, followed by several additional analyses to evaluate and control channelling bias. RESULTS: The IRRs of cardiac arrhythmias or myocardial ischaemia among users of olodaterol (n = 14 239) compared to users of other LABAs (n = 51 167) ranged from 0.96 to 1.65 in various analyses, although some estimates had low precision. Initial analysis suggested an increased risk for death with olodaterol compared with other LABAs (IRR, 1.63; 95% CI, 1.44–1.84). Because olodaterol prescribing was associated with COPD severity, the mortality association was attenuated by using different methods of tighter confounding control: the IRRs were 1.26 (95% CI, 0.97–1.64) among LABA‐naïve LABA/LAMA users without recent COPD hospitalisation; 1.27 (95% CI, 1.03–1.57) in a population with additional trimming from the tails of the PS distribution; and 1.32 (95% CI, 1.19–1.48) after applying overlap‐weights analysis. CONCLUSIONS: Olodaterol users had a similar risk for cardiac arrhythmias or myocardial ischaemia as other LABA users. The observed excess all‐cause mortality associated with olodaterol use could be due to uncontrolled channelling bias.
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spelling pubmed-95457252022-10-14 Cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists Rebordosa, Cristina Farkas, Dóra Körmendiné Montonen, Jukka Laugesen, Kristina Voss, Florian Aguado, Jaume Bothner, Ulrich Rothman, Kenneth J. Zint, Kristina Mines, Daniel Ehrenstein, Vera Pharmacoepidemiol Drug Saf Original Articles PURPOSE: We examined the effect of olodaterol on the risk of myocardial ischaemia, cardiac arrhythmia, and all‐cause mortality compared with use of other long‐acting beta2‐agonists (LABAs). Channelling bias was also explored. METHODS: This Danish population‐based cohort study used data linked from registries of hospital diagnoses, outpatient dispensings, and deaths. It included patients (aged ≥40 years) with a diagnosis of chronic obstructive pulmonary disease (COPD) who initiated olodaterol or another LABA. Using matching and propensity score (PS) stratification, we calculated adjusted incidence rate ratios (IRRs) using Poisson regression, followed by several additional analyses to evaluate and control channelling bias. RESULTS: The IRRs of cardiac arrhythmias or myocardial ischaemia among users of olodaterol (n = 14 239) compared to users of other LABAs (n = 51 167) ranged from 0.96 to 1.65 in various analyses, although some estimates had low precision. Initial analysis suggested an increased risk for death with olodaterol compared with other LABAs (IRR, 1.63; 95% CI, 1.44–1.84). Because olodaterol prescribing was associated with COPD severity, the mortality association was attenuated by using different methods of tighter confounding control: the IRRs were 1.26 (95% CI, 0.97–1.64) among LABA‐naïve LABA/LAMA users without recent COPD hospitalisation; 1.27 (95% CI, 1.03–1.57) in a population with additional trimming from the tails of the PS distribution; and 1.32 (95% CI, 1.19–1.48) after applying overlap‐weights analysis. CONCLUSIONS: Olodaterol users had a similar risk for cardiac arrhythmias or myocardial ischaemia as other LABA users. The observed excess all‐cause mortality associated with olodaterol use could be due to uncontrolled channelling bias. John Wiley & Sons, Inc. 2022-05-13 2022-08 /pmc/articles/PMC9545725/ /pubmed/35320605 http://dx.doi.org/10.1002/pds.5432 Text en © 2022 Boehringer Ingelheim International GmbH. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Rebordosa, Cristina
Farkas, Dóra Körmendiné
Montonen, Jukka
Laugesen, Kristina
Voss, Florian
Aguado, Jaume
Bothner, Ulrich
Rothman, Kenneth J.
Zint, Kristina
Mines, Daniel
Ehrenstein, Vera
Cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists
title Cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists
title_full Cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists
title_fullStr Cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists
title_full_unstemmed Cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists
title_short Cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists
title_sort cardiovascular events and all‐cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long‐acting beta2‐agonists
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545725/
https://www.ncbi.nlm.nih.gov/pubmed/35320605
http://dx.doi.org/10.1002/pds.5432
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