title: Cardiovascular, cerebrovascular, and hepatic safety of desvenlafaxine for 1 year in women with vasomotor symptoms associated with menopause.
abstract: OBJECTIVE
  A previous trial of the serotonin-norepinephrine reuptake inhibitor desvenlafaxine (administered as desvenlafaxine succinate) raised concerns on potential serious cardiovascular and hepatic events. The current study was designed to estimate these events in desvenlafaxine versus placebo in a larger population followed for 1 year.
  
  
  METHODS
  Healthy postmenopausal women seeking treatment of vasomotor symptoms were randomized to placebo or desvenlafaxine 100 mg/day in a 1-year, multicenter, double-blind study. Safety was monitored throughout. Potential ischemic cardiovascular events (coronary heart disease-related death, new-onset myocardial infarction or unstable angina requiring hospitalization, and unscheduled revascularization procedures) and cerebrovascular events (definite stroke or probable stroke) identified by investigator reports and periodic adverse event review based on Standardized medical dictionary for regulatory activities Query were reviewed by blinded adjudication boards. Hepatic events (aspartate aminotransferase or alanine aminotransferase >5 times the upper limit of normal) were evaluated.
  
  
  RESULTS
  A total of 2,118 participants (1,066 desvenlafaxine, 1,052 placebo) took one or more doses of study medication (mean, 280 d). There was one cardiovascular event; a placebo-treated participant was adjudicated to have had a myocardial infarction. One desvenlafaxine-treated participant was adjudicated to have had a probable stroke. Two participants in each treatment group had hepatic events. The excess risk (90% CI) of desvenlafaxine over placebo per 1,000 woman-years was -1.07 (-2.86 to 0.72) for cardiovascular events, 1.11 (-0.68 to 2.9) for cerebrovascular events, and 0.08 (-3.51 to 3.67) for hepatic events.
  
  
  CONCLUSIONS
  There is no evidence for an increased risk of cardiovascular, cerebrovascular, or hepatic events associated with desvenlafaxine 100 mg/day compared with placebo for the treatment of menopausal vasomotor symptoms.
authors.affiliation: Clinical Research Center, Eastern Virginia Medical School, Norfolk, VA 23507, USA. archerdf@evms.edu
authors.forename: David F
authors.initials: DF
authors.lastname: Archer
authors.forename: Joann V
authors.initials: JV
authors.lastname: Pinkerton
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Guico-Pabia
authors.forename: Eunhee
authors.initials: E
authors.lastname: Hwang
authors.forename: Ru-Fong J
authors.initials: RF
authors.lastname: Cheng
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000139:chemically induced* / Q000453:epidemiology; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology*; D003511:Cyclohexanols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000069468:Desvenlafaxine Succinate; D004311:Double-Blind Method; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D010919:Placebos; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D003511:Cyclohexanols; D010919:Placebos; D000069468:Desvenlafaxine Succinate