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Thursday, December 13, 2012

Varenicline (Chantix) in smoking cessation: to be or not to be?

Tobacco smoking is a major risk factor for cardiovascular and many other chronic diseases. The health benefits of quitting smoking are substantial. Varenicline, as part of a program, is an effective tool to help patients quit smoking. The cardiovascular safety of varenicline was questioned. The results of a meta-analysis conducted by the US Food and Drug Administration (FDA) from 7,002 patients (4,190 Chantix and 2,812 placebo) enrolled in 15 Pfizer-sponsored, randomised, double-blind, placebo-controlled clinical trials (December 12, 2012). Although “cardiovascular events were uncommon in both” groups and the “increased risk was not statistically significant,” “a higher occurrence of major adverse cardiovascular events (a combined outcome of cardiovascular-related death, nonfatal myocardial infarction [MI], and nonfatal stroke) was observed in patients using varenicline (Chantix) to aid in smoking cessation, compared with placebo.”

What should we say to the patients on treatment?
When should we initiate a varenicline treatment?

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