Düsseldorf, Germany—Smokers who develop lung disease are most in need of tools to help them kick the habit. The problem had been, however, that physicians were reluctant to prescribe the most effective medications because of suggested links to cardiovascular disease and depression.
Now, a study published in the journal Thorax reports that those concerns are largely unwarranted in patients with chronic obstructive pulmonary disease (COPD).
“COPD is irreversible and worsens with time,” noted lead author Daniel Kotz, PhD, of the University of Düsseldorf. “The only proven way to stop the illness from progressing is to quit tobacco smoking.”
For the retrospective cohort study, researchers tapped into data from 14,350 patients with COPD included in the QResearch database, which contains data from 753 National Health Service general practices across England.
Identified were patients with COPD who had received a prescription of nicotine replacement therapy (NRT), bupropion, or varenicline in the period between January 2007 and June 2012.
In a 6-month follow-up, patient records were reviewed for incident cardiovascular conditions such as ischemic heart disease, stroke, heart failure, peripheral vascular disease, and cardiac arrhythmia, as well as neuropsychiatric events, including depression and self-harm.
Results suggest that neither the bupropion nor varenicline groups had an increased risk of adverse events compared with NRT. In fact, varenicline was associated with a significantly reduced risk of heart failure—hazard ratio (HR) of 0.56—and depression—HR of 0.73.
“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 NRT,” study authors conclude.
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