Adverse events among COPD patients treated with long-acting anticholinergics and β2-agonists in an outpatient respiratory clinic

Abstract Background Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in Canada. Most patients with COPD receive long-term treatment with long-acting anticholinergics (LAAC) and/or long-acting β2-agonists (LABA). Adverse events (AEs) are also likely during long-term treatment with these medications. Objective To evaluate the prevalence of AEs in COPD patients on LAAC and LABA in a real-world setting. Methods We conducted a cross-sectional study of patients enrolled in the Registre de Donnees en Sante Pulmonaire (RESP) database, which records information on Canadian patients with asthma or COPD. COPD Patients completed a questionnaire about AEs that may be associated with LAAC and/or LABA. The prevalence of AEs and the corresponding 95% CI were calculated for three groups of patients (LAAC + LABA, LAAC alone, and LABA alone). Results Most patients with COPD ( n  = 154) were current or ex-smokers. Over 50% of patients were overweight or obese, and had an annual family income of less or equal to $42,000. Dry mouth (55.2%, 40%, and 43.5%) and dry throat (33.6%, 26.7%, and 34.8%) occurred most of the time or always in the LAAC + LABA, LAAC, and LABA groups, respectively. Headache was reported by 17.4% of patients in the LABA group, but less than 11.2% in the other groups. Conclusion AEs reported in this study deserve clinical attention because they may negatively affect quality of life and treatment adherence of COPD patients.