PMID- 29379674
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2155-6660 (Print)
IS  - 2155-6660 (Electronic)
IS  - 2155-6660 (Linking)
VI  - 7
IP  - 1
DP  - 2018
TI  - Clinical tolerability of generic versus brand beta blockers in heart failure with 
      reduced left ventricular ejection fraction: a retrospective cohort from heart 
      failure clinic.
PG  - 8-13
LID - 10.1080/21556660.2018.1423988 [doi]
AB  - Background: Beta-blockers have been shown to decrease mortality and morbidity in 
      heart failure with reduced ejection fraction (HFrEF) patients. However, the side 
      effects are also dose-related, leading to the underdosing. Cost constraint may be 
      one of the limitations of appropriate beta-blocker use; this can be improved with 
      generic drugs. However, the effects in real life practice have not been 
      investigated. Methods and results: This study aimed to compare the efficacy and 
      safety of generic and brand beta-blockers in HFrEF patients. We performed a 
      retrospective cohort analysis in HFrEF patients who received either generic or 
      brand beta-blocker in Chiang Mai Heart Failure Clinic. The primary endpoint was 
      the proportion of patients who received at least 50% target dose of beta-blocker 
      between generic and brand beta-blockers. Adverse events were secondary endpoints. 
      217 patients (119 and 98 patients received generic and brand beta-blocker, 
      respectively) were enrolled. There were no differences between groups regarding 
      age, gender, etiology of heart failure, New York Heart Association (NYHA) 
      functional class, left ventricular ejection fraction (LVEF), rate of receiving 
      angiotensin converting enzyme inhibitor (ACEI), angiotensin recepter blocker 
      (ARB), or spironolactone. Patients receiving brand beta-blockers had lower 
      resting heart rate at baseline (74.9 and 84.2 bpm, p = .001). Rate of achieved 
      50% target dose and target daily dose did not differ between groups (40.4 versus 
      44.5% and 48.0 versus 55.0%, p > .05, respectively). Rate of side effects was not 
      different between groups (32.3 versus 29.5%, p > .05) and the most common side 
      effect was hypotension. Conclusion: This study demonstrated that beta-blocker 
      tolerability was comparable between brand and generic formulations. Generic or 
      brand beta-blockers should be prescribed to HFrEF patients who have no 
      contraindications.
FAU - Chanchai, Rattanachai
AU  - Chanchai R
AD  - Northern Cardiac Center, Faculty of Medicine, Chiang Mai UniversityChiang 
      MaiThailand.
FAU - Kanjanavanit, Rungsrit
AU  - Kanjanavanit R
AD  - Northern Cardiac Center, Faculty of Medicine, Chiang Mai UniversityChiang 
      MaiThailand.
AD  - Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityChiang 
      MaiThailand.
FAU - Leemasawat, Krit
AU  - Leemasawat K
AD  - Northern Cardiac Center, Faculty of Medicine, Chiang Mai UniversityChiang 
      MaiThailand.
FAU - Amarittakomol, Anong
AU  - Amarittakomol A
AD  - Northern Cardiac Center, Faculty of Medicine, Chiang Mai UniversityChiang 
      MaiThailand.
FAU - Topaiboon, Paleerat
AU  - Topaiboon P
AD  - Northern Cardiac Center, Faculty of Medicine, Chiang Mai UniversityChiang 
      MaiThailand.
FAU - Phrommintikul, Arintaya
AU  - Phrommintikul A
AD  - Northern Cardiac Center, Faculty of Medicine, Chiang Mai UniversityChiang 
      MaiThailand.
AD  - Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityChiang 
      MaiThailand.
LA  - eng
PT  - Journal Article
DEP - 20180111
PL  - England
TA  - J Drug Assess
JT  - Journal of drug assessment
JID - 101672979
PMC - PMC5769774
OTO - NOTNLM
OT  - Beta-blocker
OT  - brand drug
OT  - generic drug
OT  - heart failure
OT  - tolerability
EDAT- 2018/01/31 06:00
MHDA- 2018/01/31 06:01
PMCR- 2018/01/01
CRDT- 2018/01/31 06:00
PHST- 2017/12/06 00:00 [received]
PHST- 2017/12/23 00:00 [accepted]
PHST- 2018/01/31 06:00 [entrez]
PHST- 2018/01/31 06:00 [pubmed]
PHST- 2018/01/31 06:01 [medline]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 1423988 [pii]
AID - 10.1080/21556660.2018.1423988 [doi]
PST - epublish
SO  - J Drug Assess. 2018 Jan 11;7(1):8-13. doi: 10.1080/21556660.2018.1423988. 
      eCollection 2018.