Data pulled from the FDA’s Adverse Event Reporting System (AERS) between October and December of 2008 suggested that Chantix may be linked to the side effects. The FDA will continue to monitor Chantix for an unspecified length of time until it determines what, if any, regulatory action is needed.

The FDA does not fully test prescription drugs for safety before allowing them to enter into the market. Why? It’s a matter of logistics more than anything. Typically, FDA studies are designed to measure a drug’s effectiveness using thousands of patients who willingly participate in pre-market clinical trials. These patients obviously represent a very small slice of U.S. population. The FDA also relies on studies conducted by the pharmaceutical companies themselves to determine how effective test drugs are. If new drugs that have passed tests for efficacy appear to be reasonably safe, then FDA researchers give them the green light.

The FDA, incidentally, reviewed Chantix in six months rather than the regular review time of 10 months.

The millions of people in the U.S. and around the world who started taking Chantix when it debuted on the world market in May 2006 became patients in the world’s first mass clinical trial. Most people assume that the FDA seal of approval means that the drug will be perfectly safe, but the truth is that most of a drug’s risks are not known until it is prescribed to millions of consumers.

The first reports of adverse events linked to Chantix emerged just months after the drug was released to the public. On February 1, 2008, the FDA issued a statement saying “it appears increasingly likely that there is an association between Chantix and serious neuropsychiatric symptoms.”

By May 2008, Chantix was linked to more than 3,000 reports of serious side effects. By November of the same year, data from the FDA’s Adverse Event Reporting System showed that more reported serious injuries resulted from Chantix than any other prescription drug.

SOURCE: Chantix Recall › FDA monitoring Chantix for serious risks, new safety concerns

The Journal Sentinel explains that Wisconsin physicians must complete 30 credits worth of continuing medical education (CME) courses every 2 years by law. The courses, which UW offers online, earn doctors up to 2 credits per course. Of the 9 online CME courses, the Journal Sentinel found that 4 were funded by pharmaceutical companies. Doctors may take those courses free of charge, but must pay a fee to enroll in any of the university-funded courses.

Pfizer is one of the companies funding an online course at UW that instructs doctors how to help their patients quit smoking. Pfizer gave UW $12.3 million for the course, which showcases Chantix as the latest and greatest smoking cessation method. The course materials do not mention the serious risks of taking Chantix, even though numbers pulled from the Food and Drug Administration’s Adverse Event Reporting System revealed that Chantix topped the list of the country’s most dangerous drugs.

Chantix has developed a favorable reputation among some people who have successfully quit smoking while taking the drug, but it has also been linked to a number of suicides and other episodes of abnormal and psychotic behavior.

Another CME course on premenstrual dysphoric disorder offered by UW is also funded by Pfizer. The course was designed by psychiatrists who have financial ties to the drug company. The course cites Xanax as a form of treatment for the disorder, “but fails to point out that only 37% of women who took it had significant improvement, compared with 30% who got a placebo.

The course also does not mention Xanax’s side effects, including the potential of dependency,” said the Journal Sentinel. “Several of the drugs promoted in the course are not approved by the FDA to treat the condition and have serious side effects not mentioned on the course Web site, including depression, stroke and blood clots,” the paper reported.

The Journal Sentinel points out that no written agreement between the drug companies and the university exists, but reciprocation is nevertheless expected.

“What you are seeing in Wisconsin is just another example of what is going on all over the country,” Arnold Relman, professor emeritus at Harvard Medical School and a former editor of the New England Journal of Medicine, told the Journal Sentinel.

“It’s unethical, and it is not in the public interest because it is going to bias doctors to use certain drugs,” he told the paper.

Daniel Carlat, a clinical professor of psychiatry at Tufts University Medical School, told the Journal Sentinel that “drug companies have found this to be a highly effective way to attract the attention of physicians.” To stay licensed, doctors must enroll in the classes. Therefore, companies such as Pfizer have a captive audience, he explained.

According to the Journal Sentinel, “Critics say the practice increases medical costs by encouraging doctors to write prescriptions for expensive brand-name drugs and by exaggerating the frequency and prevalence of rare conditions. It also promotes the use of drugs not approved for the ailments.”

Ten years ago, pharmaceutical companies spent $302 million on doctor education courses. In 2006, that amount had swollen to $1.2 billion.

“Drug companies have essentially hijacked the highest level of medical education we have in this country,” Carlat told the Journal Sentinel.

SOURCE: Chantix Recall › Pfizer and other drug companies fund medical courses

The dramatic increase of pharmaceutical drug related injuries occurred in the first three months of 2008, during which time 20,745 serious side effects and more than 4,800 deaths were reported. The incidents represent a 38 percent rise over the previous four quarters and constitute the single highest spike yet recorded.

Prescription drug related death historically accounts for 16 percent of all serious cases reported. That number soared to 23 percent in the first quarter of 2008.

According to the FDA standards, a serious drug reaction is one that leads to medical intervention or hospitalization and jeopardizes the life of the user. AERS data comes from reports that are voluntarily submitted by medical professionals. The data is generally regarded as a small representation of a much larger picture.

According to ISMP, “Some of the increases in quarterly totals could represent normal variation in the flow of reports rather than signaling a long-term trend in patient safety. However, the data are compelling and should serve as one source of information regarding drug safety in the US.”

More reported serious injuries result from Chantix usage than any other prescription drug. Chantix accounted for 1,001 new cases of serious injury, including 50 deaths.

Pfizer refuted the FDA data and ISMP’s interpretation of it. “Based on [the] totality of data, we stand by the efficacy and safety profile of Chantix when used as directed,” said Pfizer spokeswoman Kristen Neese in a statement.

SOURCE: Chantix Recall › Chantix plays role in record number of drug reactions

More than 1,000 complications were reported in the first quarter of 2008, including 15 traffic accidents, 52 incidents of loss of consciousness and blackouts, and 50 deaths.

Reports of adverse effects among users taking Chantix were greater than any other prescription drug for the second quarter in a row.

While the drug already urges caution while driving and operating machinery, the new reports suggest a stronger warning may be justified. The Food and Drug Administration is currently reviewing the data to determine if Chantix should carry warnings against driving and operating machinery altogether.

“FDA confirms that there are reports of accidents, including road traffic accidents, after the use of varenicline in the Adverse Event Reporting System. The FDA is reviewing these reports to see if current labeling related to accidents after varenicline is adequate,” said FDA spokesman Christopher DiFrancesco in an email to Reuters.

Earlier this year, the Federal Aviation Administration banned pilots and air traffic controllers from using Chantix. The Federal Motor Carrier Safety Administration also prohibited the use of Chantix.

“It appears that medical examiners should not certify a driver taking Chantix because the medication may adversely affect the driver’s ability to safely operate a commercial motor vehicle,” FMCSA Administrator John H. Hill said in a public statement.

Chantix sales in the U.S. declined more than a third following warnings about dangerous side effects and a subsequent suspension of Pfizer’s advertising campaign. Sales outside of the U.S. rose by 3 percent.

Chantix plays a key role in Pfizer’s financial pipeline as its other blockbuster drug Lipitor will go generic after July 2010.

SOURCE: Chantix Recall › Researchers recommend new Chantix warnings