Letters Cardiovascular outcomes with clarithromycin

Author’s reply to Blake

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1347 (Published 08 March 2016) Cite this as: BMJ 2016;352:i1347
  1. Ian C K Wong, professor
  1. Research Department of Practice and Policy, UCL School of Pharmacy, London WC1N 1AX, UK
  1. i.wong{at}ucl.ac.uk

We attempted to use three study designs to investigate the association between clarithromycin and cardiovascular outcomes in two cohorts of patients.1 2 The first was a propensity score adjusted cohort design comparing exposure to clarithromycin with exposure to amoxicillin or amoxicillin plus clavulanate potassium. The second was a self controlled case series design comparing the rate of cardiovascular events after exposure to Helicobacter pylori therapy containing clarithromycin with baseline of follow-up. The third study design was a case crossover study design comparing odds of exposure to H pylori therapy containing clarithromycin in 14 days before a cardiovascular event with the odds of exposure during control periods. The last two designs are both case-only designs using the same cohort, but the designs are very different.3 4 …

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