Cardiovascular Safety of Varenicline, Bupropion, and Nicotine Patch in Smokers
| Autor: | Neal L. Benowitz, Thomas McRae, Robert West, Serena Tonstad, David Lawrence, Robert M. Anthenelli, Lisa St Aubin, Andrew L. Pipe, J. Taylor Hays |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Nicotine patch 030204 cardiovascular system & hematology law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Double-Blind Method Randomized controlled trial Risk Factors law Internal medicine Outcome Assessment Health Care Internal Medicine medicine Clinical endpoint Humans 030212 general & internal medicine Varenicline Bupropion Original Investigation Smoking Cessation Agents business.industry Incidence Middle Aged Nicotine replacement therapy Tobacco Use Cessation Devices chemistry Cardiovascular Diseases Smoking cessation Female Smoking Cessation Bupropion hydrochloride business Mace |
| Zdroj: | JAMA Internal Medicine. 178:622 |
| ISSN: | 2168-6106 |
| DOI: | 10.1001/jamainternmed.2018.0397 |
| Popis: | IMPORTANCE: Quitting smoking is enhanced by the use of pharmacotherapies, but concerns have been raised regarding the cardiovascular safety of such medications. OBJECTIVE: To compare the relative cardiovascular safety risk of smoking cessation treatments. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, randomized, triple-dummy, placebo- and active-controlled trial (Evaluating Adverse Events in a Global Smoking Cessation Study [EAGLES]) and its nontreatment extension trial was conducted at 140 multinational centers. Smokers, with or without established psychiatric diagnoses, who received at least 1 dose of study medication (n = 8058), as well as a subset of those who completed 12 weeks of treatment plus 12 weeks of follow up and agreed to be followed up for an additional 28 weeks (n = 4595), were included. INTERVENTIONS: Varenicline, 1 mg twice daily; bupropion hydrochloride, 150 mg twice daily; and nicotine replacement therapy, 21-mg/d patch with tapering. MAIN OUTCOMES AND MEASURES: The primary end point was the time to development of a major adverse cardiovascular event (MACE: cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) during treatment; secondary end points were the occurrence of MACE and other pertinent cardiovascular events (MACE+: MACE or new-onset or worsening peripheral vascular disease requiring intervention, coronary revascularization, or hospitalization for unstable angina). RESULTS: Of the 8058 participants, 3553 (44.1%) were male (mean [SD] age, 46.5 [12.3] years). The incidence of cardiovascular events during treatment and follow-up was low ( |
| Databáze: | OpenAIRE |
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