Amiodarone-induced thyroid dysfunction: brand-name versus generic formulations - 13/09/11
Contributors: Meytal Tsadok, Cynthia Jackevicius, Elham Rahme and Louise Pilote were involved in the conception and design of the study. Meytal Tsadok, Cynthia Jackevicius, Hassan Behlouli and Louise Pilote drafted the manuscript. Meytal Tsadok, Cynthia Jackevicius, Elham Rahme, Hassan Behlouli and Louise Pilote analyzed and interpreted the data. Meytal Tsadok, Cynthia Jackevicius, Vidal Essebag, Mark Eisenberg, Karin Humphries, Jack Tu, Jennifer Joo and Louise Pilote reviewed the manuscript. All of the authors had full access to the data, and all of the authors approved the final version of the manuscript submitted for publication.
Abstract |
Background |
Amiodarone is associated with dysfunction of the thyroid. Concerns have arisen regarding the potential for adverse effects with generic formulations of amiodarone. We evaluated and compared the risk of thyroid dysfunction between patients using brand-name versus generic formulations of amiodarone and identified risk factors for thyroid dysfunction.
Methods |
We conducted a retrospective cohort study of patients with atrial fibrillation aged 66 years and older. We used administrative databases that linked information on demographics and clinical characteristics, claims for prescription drugs and discharges from hospital. We estimated thyroid dysfunction using person-year incidence.
Results |
Of the 60 220 patients in the cohort, 2804 (4.7%) used the brand-name formulation of amiodarone and 6278 (10.4%) used the generic formulation. Baseline characteristics between these two groups were comparable. The median maintenance dose of amiodarone was 200 mg/d for both groups. The total incidence rate for thyroid dysfunction was 14.1 per 100 person-years for both formulations. The mean time to clinical dysfunction of the thyroid was 4.32 years for the brand-name formulation and 4.09 years for the generic formulation. In a multivariate analysis, there was no significant difference in the incidence rates of thyroid dysfunction between the generic and brand formulations (hazard ratio 0.97, 95% confidence interval 0.87–1.08). Factors associated with an increased risk of thyroid dysfunction were being a woman, increasing age and having chronic obstructive pulmonary disease.
Interpretation |
In this population-based study, we saw no difference between brand-name and generic formulations of amiodarone in terms of incidence of thyroid dysfunction.
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| Competing interests: Meytal Tsadok, Cynthia Jackevicius and Vidal Essebag have received grants from the Canadian Institutes of Health Research. Vidal Essebag is a consultant for Sanofi Aventis and Boehringer Ingelheim and has received payment for lectures from Sanofi Aventis, Boehringer Ingelheim and Medtronic. No other competing interests were declared. This article has been peer reviewed. Funding: Financial support for this study was provided by an operating grant from the Canadian Institutes of Health Research (grant number MOP-84304). |
Vol 183 - N° 12
P. E817-E823 - septembre 2011 Retour au numéro
Article précédent
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