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Clocktower.Thursday 15 June 2017 9:23am

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Four members of the Pharmacoepidemiology Research Network at Otago: (from left) Jiaxu Zeng, Dave Barson, Lianne Parkin and Jack Dummer.

The University of Otago's Dr Lianne Parkin and colleagues will receive a Health Research Council grant to investigate whether particular drugs used to treat a common lung disease put people at greater risk of heart attacks.

The grant, worth more than $840,000, is for Dr Parkin's group, the Pharmacoepidemiology Research Network, to investigate whether the combined use of long-acting beta-agonist and anticholinergic inhalers increases the risk of acute coronary syndrome, or heart attack, in people with chronic obstructive pulmonary disease (COPD).

COPD is a chronic lung disease which is sometimes known as emphysema or chronic bronchitis, and long-acting beta-agonist and anticholinergic inhalers are widely used to treat this condition.

“COPD and acute coronary syndrome are two of the most common reasons for hospital admission and death in New Zealand, so they are important conditions”, says Dr Parkin.

“Cardiovascular disease often occurs among people with COPD and there is concern that long-acting beta-agonist and anticholinergic inhalers might increase the risk of acute coronary syndrome still further. This is an important issue because these drugs are increasingly being prescribed together and their clinical benefits are modest,” respiratory physician and co-investigator, Otago's Dr Jack Dummer, says.

The study will use anonymised pharmaceutical dispensing and health data to determine whether people using a combination of these drugs have a higher risk of acute coronary syndrome than people using anticholinergic drugs alone.

Project details:
Are treatments for COPD increasing the risk of acute coronary syndrome?

HRC funding:
$842,445, 36 months.

University of Otago Investigators:
Dr Lianne Parkin (Department of Preventive and Social Medicine, Dunedin School of Medicine), Dr Jack Dummer (Department of Medicine, Dunedin School of Medicine), Associate Professor Katrina Sharples (Department of Mathematics and Statistics; Department of Medicine, Dunedin School of Medicine), Dr Jiaxu Zeng (Department of Preventive and Social Medicine), Dr Simon Horsburgh (Department of Preventive and Social Medicine), Mr David Barson (Department of Preventive and Social Medicine).

HRC 2017-funding round Lay Summary:
Acute coronary syndrome (heart attacks and unstable angina) and chronic obstructive pulmonary disease (COPD) are among the commonest reasons for hospital admission and death in New Zealand. Māori, Pacific peoples, and lower income groups are particularly affected. Acute coronary syndrome is common among people with COPD. Inhaled long-acting bronchodilators (long-acting muscarinic antagonists [LAMAs] and long-acting beta-agonists [LABAs]) are the main drugs used to treat people with COPD. However, there is concern that both LAMAs and LABAs may further increase the risk of acute coronary syndrome. This is important because the clinical benefits of these drugs are modest and people with COPD are more likely to die from coronary events than from respiratory failure. We propose to undertake a study to determine the risk of acute coronary events in people taking LAMAs and LABAs. The study will use anonymised existing data only, no patients will be approached.

For more information, contact:

Dr Lianne Parkin
Senior Lecturer
Department of Preventive and Social Medicine
Dunedin School of Medicine
University of Otago
Email: lianne.parkin@otago.ac.nz

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