AI Article Synopsis
- The study aimed to assess the safety of generic vs. brand-name drugs in cardiology, focusing on losartan, valsartan, and candesartan, by analyzing ER visits, hospitalizations, and deaths among patients aged 66 and older in Quebec.
- Using healthcare data, researchers conducted a retrospective cohort study comparing outcomes for patients switched to generics versus those who continued with brand-name medications, while controlling for biases.
- Results indicated an increased risk of hospitalization for patients who switched to generic valsartan, but a decreased risk of death for those on generic candesartan, highlighting potential differences in health outcomes between generic and brand-name drugs.
Article Abstract
Background: It is unclear whether generics are as safe as brand-name drugs in cardiology. For public health surveillance purposes, we evaluated if switching from the brand-name losartan, valsartan, or candesartan impacted the occurrence of the following outcomes: emergency room (ER) consultations, hospitalizations, or death.
Study Design: This was a retrospective cohort study.
Methods: This study was conducted in the Quebec Integrated Chronic Disease Surveillance System, including healthcare administrative data of the population of Quebec, Canada. We included brand-name users of losartan, valsartan, or candesartan aged ≥ 66 years who had undergone ≥ 30 days of stable treatment on the brand-name drug prior to cohort entry (substitution time-distribution matching was used to prevent immortal time bias). Outcomes up to 1 year were compared between groups using multivariable Cox proportional hazards regression models (validity assumptions were verified).
Results: In our cohorts (losartan, n =15,783; valsartan, n =16,907; candesartan, n =26,178), mean age was 76-78 years, 59-66% were female, 90-92% had hypertension, and 13-15% had heart failure. Validity assumptions were violated for losartan only. For patients switched to generic valsartan, the hazard ratio (95% confidence interval) was 1.07 (0.99-1.14) for ER consultation, 1.26 (1.14-1.39) for hospitalization, and 1.01 (0.61-1.67) for death. The corresponding rates for candesartan were 1.00 (0.95-1.05), 0.96 (0.89-1.03), and 0.57 (0.37-0.88), respectively.
Conclusions: We observed an increased risk of hospitalizations for patients switched to generic valsartan, and a decreased risk of death for patients switched to generic candesartan, compared with those who continued taking the brand-name drug. The differences between generic and brand-name drugs may lead to some differences in public health outcomes, but this safety signal must be further studied using other cohorts and settings.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221012 | PMC |
| http://dx.doi.org/10.1007/s40268-020-00307-2 | DOI Listing |
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