#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Clarithromycin use and the risk of mortality and cardiovascular events: A systematic review and meta-analysis


Autoři: Ching-Hui You aff001;  Cheng-Kuan Lin aff002;  Po-Hua Chen aff001;  Suna Park aff001;  Yi-Yun Chen aff001;  Nazleen Khan aff001;  Stefania I. Papatheodorou aff001;  Szu-Ta Chen aff001
Působiště autorů: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America aff001;  Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226637

Souhrn

Background

Although studies reported increased cardiovascular (CV) risks in patients treated with macrolides, the risks remain controversial among clarithromycin (CLR) users. We aimed to summarize the association between CLR use and the risks of mortality and CV events.

Methods

We searched PubMed, EMBASE, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) and observational studies with population exposed to CLR published until December 31st, 2018. These studies reported either all-cause mortality (primary outcome) or CV adverse events (secondary outcomes) based on multivariate models. Effect measures were synthesized by study design and follow-up duration (long-term, ≥ 1 year; short-term, ≤ 3 months; and immediate, ≤ 2 weeks). This study has been registered on PROSPERO (ID: CRD42018089605).

Results

This meta-analysis included 13 studies (3 RCTs and 10 observational studies) and 8,351,815 subjects (1,124,672 cases and 7,227,143 controls). Overall, CLR use was not associated with increased long-term all-cause mortality (pooled rate ratio RR = 1.09, 95% CI = 0.91–1.32), either among patients with or without comorbidities of cardiovascular diseases. Comparing CLR users to placebo, there is no additional risks of cardiac mortality (pooled RR = 1.03, 95% CI = 0.53–2.01), acute myocardial infarction (pooled RR = 1.29, 95% CI = 0.98–1.68), and arrhythmia (pooled RR = 0.90, 95% CI = 0.62–1.32).

Conclusions

Our findings suggested no significant association between CLR use and subsequent long-term all-cause mortality, regardless having comorbidity of cardiovascular diseases or not. Further RCTs investigating the short-term CV risks of CLR use compared to alternative antibiotics are warranted, particularly in high-risk populations.

Klíčová slova:

Antibiotics – Arrhythmia – Comparators – Death rates – Myocardial infarction – Observational studies – Randomized controlled trials


Zdroje

1. Outpatient antibiotic prescription data from QuintilesIMS (formerly IMS Health) Xponent data and U.S. Census files in an interactive database. https://giscdcgov/grasp/PSA/AUMapViewhtml. 2011.

2. Lebel M. Pharmacokinetic properties of clarithromycin: A comparison with erythromycin and azithromycin. The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses. 1993;4(3):148–52. Epub 1993/05/01. doi: 10.1155/1993/168061 22346438; PubMed Central PMCID: PMC3250788.

3. Gorelik E, Masarwa R, Perlman A, Rotshild V, Muszkat M, Matok I. Systematic Review, Meta-analysis, and Network Meta-analysis of the Cardiovascular Safety of Macrolides. Antimicrobial agents and chemotherapy. 2018;62(6). Epub 2018/04/04. doi: 10.1128/aac.00438-18 29610207; PubMed Central PMCID: PMC5971614.

4. Wong AY, Root A, Douglas IJ, Chui CS, Chan EW, Ghebremichael-Weldeselassie Y, et al. Cardiovascular outcomes associated with use of clarithromycin: population based study. BMJ (Clinical research ed). 2016;352:h6926. Epub 2016/01/16. doi: 10.1136/bmj.h6926 26768836.

5. Chou HW, Wang JL, Chang CH, Lai CL, Lai MS, Chan KA. Risks of cardiac arrhythmia and mortality among patients using new-generation macrolides, fluoroquinolones, and beta-lactam/beta-lactamase inhibitors: a Taiwanese nationwide study. Clin Infect Dis. 2015;60(4):566–77. Epub 2014/11/20. doi: 10.1093/cid/ciu914 25409476.

6. Mosholder A, Lee JY, Zhou E, Kang E, Ghosh M, Izem R, et al. Long-term risk of acute myocardial infarction, stroke and death with outpatient use of clarithromycin: A retrospective cohort study. Pharmacoepidemiology and Drug Safety. 2017;26:182. doi: 10.1002/pds.4275

7. Schembri S, Williamson PA, Short PM, Singanayagam A, Akram A, Taylor J, et al. Cardiovascular events after clarithromycin use in lower respiratory tract infections: analysis of two prospective cohort studies. BMJ (Clinical research ed). 2013;346:f1235. Epub 2013/03/26. doi: 10.1136/bmj.f1235 23525864.

8. Winkel P, Hilden J, Fischer Hansen J, Kastrup J, Kolmos HJ, Kjøller E, et al. Clarithromycin for stable coronary heart disease increases all-cause and cardiovascular mortality and cerebrovascular morbidity over 10 years in the CLARICOR randomised, blinded clinical trial. International Journal of Cardiology. 2015;182(C):459–65. doi: 10.1016/j.ijcard.2015.01.020 25602299

9. The U.S. Food and Drug Administration (FDA) Safety Announcement. 2018.

10. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ (Clinical research ed). 2015;350:g7647. doi: 10.1136/bmj.g7647 25555855.

11. Sinisalo J, Mattila K, Valtonen V, Anttonen O, Juvonen J, Melin J, et al. Effect of 3 months of antimicrobial treatment with clarithromycin in acute non-q-wave coronary syndrome. Circulation. 2002;105(13):1555–60. Epub 2002/04/03. doi: 10.1161/01.cir.0000012544.07696.1f 11927522.

12. Guolo A, Varin C. Random-effects meta-analysis: the number of studies matters. Stat Methods Med Res. 2017;26(3):1500–18. Epub 2015/05/09. doi: 10.1177/0962280215583568 25953957.

13. Shor E, Roelfs D, Vang ZM. The "Hispanic mortality paradox" revisited: Meta-analysis and meta-regression of life-course differentials in Latin American and Caribbean immigrants' mortality. Soc Sci Med. 2017;186:20–33. doi: 10.1016/j.socscimed.2017.05.049 28577458.

14. Higgins JPT, Green S, Collaboration TC. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2: Cochrane Collaboration; 2008.

15. GA Wells BS, D O'Connell, J Peterson, V Welch, M Losos, P Tugwell, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from URL: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.

16. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clinical research ed). 2003;327(7414):557–60. Epub 2003/09/06. doi: 10.1136/bmj.327.7414.557 12958120; PubMed Central PMCID: PMC192859.

17. Melsen WG, Bootsma MC, Rovers MM, Bonten MJ. The effects of clinical and statistical heterogeneity on the predictive values of results from meta-analyses. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2014;20(2):123–9. Epub 2013/12/11. doi: 10.1111/1469-0691.12494 24320992.

18. Berg HF, Maraha B, Scheffer GJ, Quarles-Van Ufford M, Vandenbroucke-Grauls CMJE, Peeters MF, et al. Treatment with clarithromycin prior to coronary artery bypass graft surgery does not prevent subsequent cardiac events. Clinical Infectious Diseases. 2005;40(3):358–65. doi: 10.1086/427111 15668857

19. Sutton SS, Hyche S, Magagnoli J, Hardin JW. Appraisal of the cardiovascular risks of azithromycin: an observational analysis. J Comp Eff Res. 2017;6(6):509–17. Epub 2017/09/30. doi: 10.2217/cer-2016-0080 28960092.

20. Berni E, de Voogd H, Halcox JP, Butler CC, Bannister CA, Jenkins-Jones S, et al. Risk of cardiovascular events, arrhythmia and all-cause mortality associated with clarithromycin versus alternative antibiotics prescribed for respiratory tract infections: a retrospective cohort study. BMJ open. 2017;7(1):e013398. Epub 2017/01/25. doi: 10.1136/bmjopen-2016-013398 28115334; PubMed Central PMCID: PMC5278300.

21. Inghammar M, Nibell O, Pasternak B, Melbye M, Svanstrom H, Hviid A. Long Term Risk of Cardiovascular Death With Use of Clarithromycin and Roxithromycin—a Nationwide Cohort Study. Am J Epidemiol. 2017. Epub 2017/11/21. doi: 10.1093/aje/kwx359 29155931.

22. Andersen SS, Hansen ML, Norgaard ML, Folke F, Fosbøl EL, Abildstrøm SZ, et al. Clarithromycin use and risk of death in patients with ischemic heart disease. Cardiology. 2010;116(2):89–97. doi: 10.1159/000315394 20523043

23. Svanström H, Pasternak B, Hviid A. Use of clarithromycin and roxithromycin and risk of cardiac death: Cohort study. BMJ (Online). 2014;349. doi: 10.1136/bmj.g4930 25139799

24. Hutson JR, Fischer HD, Wang X, Gruneir A, Daneman N, Gill SS, et al. Use of clarithromycin and adverse cardiovascular events among older patients receiving donepezil: a population-based, nested case-control study. Drugs Aging. 2012;29(3):205–11. Epub 2012/03/01. doi: 10.2165/11599090-000000000-00000 22372724.

25. Wong AYS, Chan EW, Anand S, Worsley AJ, Wong ICK. Managing Cardiovascular Risk of Macrolides: Systematic Review and Meta-Analysis. Drug Saf. 2017;40(8):663–77. doi: 10.1007/s40264-017-0533-2 28397186.

26. Abo-Salem E, Fowler JC, Attari M, Cox CD, Perez-Verdia A, Panikkath R, et al. Antibiotic-induced cardiac arrhythmias. Cardiovasc Ther. 2014;32(1):19–25. doi: 10.1111/1755-5922.12054 24428853.

27. Cheng YJ, Nie XY, Chen XM, Lin XX, Tang K, Zeng WT, et al. The Role of Macrolide Antibiotics in Increasing Cardiovascular Risk. Journal of the American College of Cardiology. 2015;66(20):2173–84. Epub 2015/11/14. doi: 10.1016/j.jacc.2015.09.029 26564594.

28. Ngeh J, Anand V, Gupta S. Chlamydia pneumoniae and atherosclerosis—what we know and what we don't. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2002;8(1):2–13. Epub 2002/03/22. doi: 10.1046/j.1469-0691.2002.00382.x 11906495.

29. Jensen JS, Bielefeldt AO, Hrobjartsson A. Active placebo control groups of pharmacological interventions were rarely used but merited serious consideration: a methodological overview. J Clin Epidemiol. 2017;87:35–46. Epub 2017/03/28. doi: 10.1016/j.jclinepi.2017.03.001 28342907.

30. Gluud C, Als-Nielsen B, Damgaard M, Fischer Hansen J, Hansen S, Helo OH, et al. Clarithromycin for 2 weeks for stable coronary heart disease: 6-year follow-up of the CLARICOR randomized trial and updated meta-analysis of antibiotics for coronary heart disease. Cardiology. 2008;111(4):280–7. Epub 2008/05/03. doi: 10.1159/000128994 18451646; PubMed Central PMCID: PMC2820332.


Článek vyšel v časopise

PLOS One


2019 Číslo 12
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

Svět praktické medicíny 3/2024 (znalostní test z časopisu)
nový kurz

Kardiologické projevy hypereozinofilií
Autoři: prof. MUDr. Petr Němec, Ph.D.

Střevní příprava před kolonoskopií
Autoři: MUDr. Klára Kmochová, Ph.D.

Aktuální možnosti diagnostiky a léčby litiáz
Autoři: MUDr. Tomáš Ürge, PhD.

Závislosti moderní doby – digitální závislosti a hypnotika
Autoři: MUDr. Vladimír Kmoch

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#