Are Smoking Cessation Treatments Safe for Patients with COPD?
Varenicline and bupropion were not associated with an increased risk for adverse events in smokers with chronic obstructive pulmonary disease (COPD), according to the findings of a new study.
The retrospective cohort study included data from 14,350 patients with COPD located on the QResearch database. Between January 2007 and June 2012, researchers identified 10,427 patients who received nicotine replacement therapy, 350 patients with COPD who received bupropion, and 3574 patients with COPD who received varenicline. Incidents of cardiovascular events, such as ischemic heart disease, stroke, heart failure, peripheral vascular disease, cardia arrhythmias, and neuropsychiatric events, such as depression and self-harm, were obtained during 6 months of follow-up.
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Compared with nicotine replacement therapy, bupropion and varenicline was not associated with an increased risk for adverse events in patients with COPD. In addition, the researchers found that varenicline significantly reduced the risk of heart failure and depression.
Propensity score analysis showed similar results, and the modelling of unmeasured confounding also showed that an increased risk of neuropsychiatric and cardiovascular events was unlikely for either treatment.
“In smokers with COPD, varenicline and bupropion do not appear to be associated with an increased risk of cardiovascular events, depression or self-harm in comparison with [nicotine replacement therapy],” the researchers concluded.
—Melissa Weiss
Reference:
Kotz D, Viechtbauer W, Simpson CR, van Schayck OCP, West R, and Sheikh A. Cardiovascular and neuropsychiatric risks of varenicline and bupropion in smokers with chronic obstructive pulmonary disease [published online May 4, 2017]. Thorax. doi:10.1136/thoraxjnl-2017-210067.