Increased CV risk with smoking cessation drug varenicline: New meta-analysis

Posted by: admin on: December 23, 2011

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A debate is raised as to the benefits versus risk of using of varenicline for stopping smoking. ‘The benefits of stopping smoking vastly outweigh any side effects of a drug that is only taken for a short term is’ is the counter argument against the risk of using the drug.

Team@CMHF.

A new meta-analysis is raising fresh concerns about the cardiovascular risk associated with the smoking-cessation drug varenicline (Chantix, Pfizer) MedWatch data show that it is one of the worst drugs on the market in terms of side effects. “It is associated with sudden loss of consciousness, which has led it to be banned from use in pilots and truck drivers, and the Department of Defense has discouraged its use in army personnel working with missiles. But question arises about all the people who drive cars every day. It also has the most reports of aggression, hostility, and violence of any drug marketed, and these are only the reactions that have actually been reported to the FDA and so just represent the tip of the iceberg.” The next focus is on reports of suicide and self-inflicted injury with the drug, with a paper on this subject currently in review.

People in favor of withdrawing the drug argue, “We all know the harms of smoking, and not disputing the need to quit. But we should advocate using a different method to help people quit. There are lots of other aids that work without increasing cardiovascular risk.”

Benefit is only modest. The efficacy is weak. And the adverse events are piling up.
It is an exceedingly potent drug that blocks nerve impulses in the brain.
There are other options for smoking cessation.” He believes counseling should be the main method to help people quit smoking. “People need moral support to keep their willpower, but physicians are not trained to do this.”

One group was more worried about the CNS effects than the cardiovascular effects of the drug. They observed, “The CNS effects are real. Think twice before prescribing this drug to anyone with mental-health issues, and should discuss these risks with patients or the parents/spouses of patients to make them alert for any changes in emotion.

People in favor varenicline say that the absolute cardiovascular risk appeared low and is okay, if it avoids the downstream risks associated with smoking

Commenting on the issue of the CNS side effects, Pfizer mentioned that “there is no reliable scientific evidence to say these events are caused by varenicline (Chantix).” It added, however, that it is planning a large trial of varenicline in smokers with and without mental-health disorders to look at this further.

The company adds that: “The health benefits of quitting smoking are immediate and substantial” and that “each year, an estimated 5.4 million people worldwide die from smoking-related causes.

These results represent a significant degree of uncertainty about the relative good or harm from varenicline, leaving the issue unsettled.

Reference: http://www.theheart.org/article/1248291.do

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