Evidence map›Paper›PMID 28605035›Full record

ArticleClinical cardiology2017

Cardiovascular adverse events in the drug-development program of bupropion for smoking cessation: A systematic retrospective adjudication effort.

Jessie Kittle, Renato D Lopes, Mingyan Huang, Marsha L Marquess, Matthew D Wilson, John Ascher, Alok Krishen, Vic Hasselblad, Brad J Kolls, Matthew T Roe and 3 more

Abstract read
In one paragraph

Article in Clinical cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jessie KittleStanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Renato D LopesDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.ORCID http://orcid.org/0000-0003-2999-4961
Mingyan HuangDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
Marsha L MarquessDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
Matthew D WilsonDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
John AscherGlaxoSmithKline, Research Triangle Park, North Carolina.
Alok KrishenPAREXEL International on behalf of GlaxoSmithKline, Durham, North Carolina.
Vic HasselbladDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
Brad J KollsDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
Matthew T RoeDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.ORCID http://orcid.org/0000-0002-4049-3458
Darren K McGuireDepartment of Internal Medicine-Cardiology, University of Texas Southwestern Medical Center, Dallas.
Stuart D RussellDepartment of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
Kenneth W MahaffeyStanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, California.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2011, the US Food and Drug Administration requested that GlaxoSmithKline perform retrospective adjudication of cardiovascular (CV) events reported in the bupropion drug-development trials for smoking cessation. HYPOTHESIS: Retrospective adjudication of clinical trial data will not increase the identification of adverse events.

methodsWe performed a comprehensive retrospective analysis of adverse events in 19 previously completed controlled US clinical trials of bupropion marketed for the treatment of smoking cessation, yielding 9479 subjects (5290 bupropion, 2927 placebo, 1018 active control [ACT], and 244 treated concurrently with bupropion and ACT). All adverse events were sent to the Duke Clinical Research Institute for adjudication by Clinical Events Classification (CEC) physician reviewers. The primary endpoint was a composite of major adverse CV events: CV death, nonfatal myocardial infarction (MI), and nonfatal stroke.

resultsOverall, 416 nonfatal CV events in 366 subjects, and 22 deaths, were identified and processed for adjudication. Of these, 7 nonfatal MIs (4 bupropion, 3 placebo, 0 ACT), 5 nonfatal strokes (1 bupropion, 3 placebo, 1 ACT), and 9 CV deaths (4 bupropion, 4 placebo, 1 ACT) were confirmed by the CEC Committee. The primary endpoint occurred in 3/4297 (0.07%) subjects in the bupropion group and in 4/2927 (0.14%) subjects in the placebo group (log-rank P value: 0.613).

conclusionsCV events in bupropion clinical trials for smoking cessation were uncommon, with no observed increase among subjects assigned to bupropion vs placebo. However, this effort was limited by a paucity of quality data.

Indexed as

AdultBupropionCardiotoxicityCardiovascular DiseasesDrug DiscoveryFemaleHumansMaleMiddle AgedMyocardial InfarctionRandomized Controlled Trials as TopicRetrospective StudiesRisk AssessmentRisk FactorsSmoking CessationStrokeBupropionAdjudicationAdverse Cardiovascular EventsBupropionSmoking CessationSystematic Review

Identifiers

PMID28605035
PMCPMC6490529

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.