VIDEO: Search for genetic risk factors may improve vincristine therapy

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Discovery of a genetic variation that may boost the risk of peripheral neuropathy for some cancer patients on vincristine therapy could lead to better treatment regimens for those patients.

Investigators uncovered the genetic variation in a study that analyzed DNA samples from 321 children with acute lymphoblastic leukemia who received standard vincristine therapy while participating in two prospective clinical trials (JAMA 2015 Feb. 24 [doi:10.1001/jama.2015.0894]).

William E. Evans, Pharm.D., and Kristine R. Crews, Pharm.D., both of St. Jude Children’s Research Hospital, Memphis, Tenn., discussed what spurred the search for genetic risk factors and what’s next for researchers looking to cut the chance of side effects associated with vincristine treatment in a video interview.

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Discovery of a genetic variation that may boost the risk of peripheral neuropathy for some cancer patients on vincristine therapy could lead to better treatment regimens for those patients.

Investigators uncovered the genetic variation in a study that analyzed DNA samples from 321 children with acute lymphoblastic leukemia who received standard vincristine therapy while participating in two prospective clinical trials (JAMA 2015 Feb. 24 [doi:10.1001/jama.2015.0894]).

William E. Evans, Pharm.D., and Kristine R. Crews, Pharm.D., both of St. Jude Children’s Research Hospital, Memphis, Tenn., discussed what spurred the search for genetic risk factors and what’s next for researchers looking to cut the chance of side effects associated with vincristine treatment in a video interview.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

Discovery of a genetic variation that may boost the risk of peripheral neuropathy for some cancer patients on vincristine therapy could lead to better treatment regimens for those patients.

Investigators uncovered the genetic variation in a study that analyzed DNA samples from 321 children with acute lymphoblastic leukemia who received standard vincristine therapy while participating in two prospective clinical trials (JAMA 2015 Feb. 24 [doi:10.1001/jama.2015.0894]).

William E. Evans, Pharm.D., and Kristine R. Crews, Pharm.D., both of St. Jude Children’s Research Hospital, Memphis, Tenn., discussed what spurred the search for genetic risk factors and what’s next for researchers looking to cut the chance of side effects associated with vincristine treatment in a video interview.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

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VIDEO: True remission necessary before tapering or discontinuing RA drugs

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VIDEO: True remission necessary before tapering or discontinuing RA drugs

MAUI, HAWAII– Discontinuing medications when rheumatoid arthritis patients are doing well is a hot topic in rheumatology lately, but it’s tricky.

The idea is to give patients a break from the costs and side effects of steroids, methotrexate, and biologics. Whether or not doing so is a good idea has a lot to do with how you define remission, and the odds of recapturing patients if they flare.

Advice from Dr. Roy Fleischmann, a clinical professor of rheumatology at the University of Texas Southwestern Medical Center in Dallas, might help. At the 2015 Rheumatology Winter Clinical Symposium, he shared his know-how about tapering and discontinuing treatments, culled from his professional experience and the literature on the subject in a video interview.

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MAUI, HAWAII– Discontinuing medications when rheumatoid arthritis patients are doing well is a hot topic in rheumatology lately, but it’s tricky.

The idea is to give patients a break from the costs and side effects of steroids, methotrexate, and biologics. Whether or not doing so is a good idea has a lot to do with how you define remission, and the odds of recapturing patients if they flare.

Advice from Dr. Roy Fleischmann, a clinical professor of rheumatology at the University of Texas Southwestern Medical Center in Dallas, might help. At the 2015 Rheumatology Winter Clinical Symposium, he shared his know-how about tapering and discontinuing treatments, culled from his professional experience and the literature on the subject in a video interview.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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MAUI, HAWAII– Discontinuing medications when rheumatoid arthritis patients are doing well is a hot topic in rheumatology lately, but it’s tricky.

The idea is to give patients a break from the costs and side effects of steroids, methotrexate, and biologics. Whether or not doing so is a good idea has a lot to do with how you define remission, and the odds of recapturing patients if they flare.

Advice from Dr. Roy Fleischmann, a clinical professor of rheumatology at the University of Texas Southwestern Medical Center in Dallas, might help. At the 2015 Rheumatology Winter Clinical Symposium, he shared his know-how about tapering and discontinuing treatments, culled from his professional experience and the literature on the subject in a video interview.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

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Consider this Tx option for insomnia: Sedating antidepressants

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VIDEO: Homeopathic injectables topped placebo for knee osteoarthritis

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VIDEO: Homeopathic injectables topped placebo for knee osteoarthritis

MAUI, HAWAII – Two homeopathic injectables, as well as the familiar combination of glucosamine and chondroitin, showed promise in two studies of alternative treatments for osteoarthritis.

In an interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Martin J. Bergman, of the department of rheumatology at Drexel University in Philadelphia, shared the recent results from the two investigations.

The first pitted intra-articular injections of two homeopathic products, Traumeel and Zeel, against placebo saline injections for knee osteoarthritis; the work was sponsored by the products’ German maker, Biologische Heilmittel Heel.

In the second trial, glucosamine and chondroitin sulfate went head to head against celecoxib (Celebrex), also for knee OA. The work was sponsored by Bioibérica, a Spanish company that makes chondroitin and glucosamine, and the investigators reported financial ties to the company.

Traumeel and Zeel may sound exotic, but they aren’t unknown in the rheumatology world – some U.S. rheumatologists are using them, Dr. Bergman, also chief of rheumatology at Taylor Hospital in Ridley Park, Pa., said.

Dr. Bergman disclosed that he has served as an advisor, speaker, or consultant for AbbVie, Amgen, Celgene, and Roche, and holds shares in Bristol-Myers Squibb, Johnson & Johnson, and Pfizer.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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MAUI, HAWAII – Two homeopathic injectables, as well as the familiar combination of glucosamine and chondroitin, showed promise in two studies of alternative treatments for osteoarthritis.

In an interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Martin J. Bergman, of the department of rheumatology at Drexel University in Philadelphia, shared the recent results from the two investigations.

The first pitted intra-articular injections of two homeopathic products, Traumeel and Zeel, against placebo saline injections for knee osteoarthritis; the work was sponsored by the products’ German maker, Biologische Heilmittel Heel.

In the second trial, glucosamine and chondroitin sulfate went head to head against celecoxib (Celebrex), also for knee OA. The work was sponsored by Bioibérica, a Spanish company that makes chondroitin and glucosamine, and the investigators reported financial ties to the company.

Traumeel and Zeel may sound exotic, but they aren’t unknown in the rheumatology world – some U.S. rheumatologists are using them, Dr. Bergman, also chief of rheumatology at Taylor Hospital in Ridley Park, Pa., said.

Dr. Bergman disclosed that he has served as an advisor, speaker, or consultant for AbbVie, Amgen, Celgene, and Roche, and holds shares in Bristol-Myers Squibb, Johnson & Johnson, and Pfizer.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

MAUI, HAWAII – Two homeopathic injectables, as well as the familiar combination of glucosamine and chondroitin, showed promise in two studies of alternative treatments for osteoarthritis.

In an interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Martin J. Bergman, of the department of rheumatology at Drexel University in Philadelphia, shared the recent results from the two investigations.

The first pitted intra-articular injections of two homeopathic products, Traumeel and Zeel, against placebo saline injections for knee osteoarthritis; the work was sponsored by the products’ German maker, Biologische Heilmittel Heel.

In the second trial, glucosamine and chondroitin sulfate went head to head against celecoxib (Celebrex), also for knee OA. The work was sponsored by Bioibérica, a Spanish company that makes chondroitin and glucosamine, and the investigators reported financial ties to the company.

Traumeel and Zeel may sound exotic, but they aren’t unknown in the rheumatology world – some U.S. rheumatologists are using them, Dr. Bergman, also chief of rheumatology at Taylor Hospital in Ridley Park, Pa., said.

Dr. Bergman disclosed that he has served as an advisor, speaker, or consultant for AbbVie, Amgen, Celgene, and Roche, and holds shares in Bristol-Myers Squibb, Johnson & Johnson, and Pfizer.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

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VIDEO: Ask patients about metal-on-metal hip implants

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MAUI, HAWAII – Rheumatologists and other providers need to ask patients if they’ve had metal-on-metal hip implants.

That goes for hip resurfacing – which by definition is metal on metal – as well as actual metal-on-metal hips. Signs of trouble can be as subtle as mental status changes, and they go well beyond the traditional issues with worn-out artificial joints.

During a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Bill Bugbee, an orthopedic surgeon and professor at the University of California, San Diego, explained the problems and the warning signs for which physicians should watch.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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MAUI, HAWAII – Rheumatologists and other providers need to ask patients if they’ve had metal-on-metal hip implants.

That goes for hip resurfacing – which by definition is metal on metal – as well as actual metal-on-metal hips. Signs of trouble can be as subtle as mental status changes, and they go well beyond the traditional issues with worn-out artificial joints.

During a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Bill Bugbee, an orthopedic surgeon and professor at the University of California, San Diego, explained the problems and the warning signs for which physicians should watch.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

MAUI, HAWAII – Rheumatologists and other providers need to ask patients if they’ve had metal-on-metal hip implants.

That goes for hip resurfacing – which by definition is metal on metal – as well as actual metal-on-metal hips. Signs of trouble can be as subtle as mental status changes, and they go well beyond the traditional issues with worn-out artificial joints.

During a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Bill Bugbee, an orthopedic surgeon and professor at the University of California, San Diego, explained the problems and the warning signs for which physicians should watch.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

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Diabetes and Steroid Use

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Many diabetic patients also have disorders such as arthritis that require treatment with steroids—but there are adverse effects, particularly in people with diabetes. What are they?

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Many diabetic patients also have disorders such as arthritis that require treatment with steroids—but there are adverse effects, particularly in people with diabetes. What are they?
Many diabetic patients also have disorders such as arthritis that require treatment with steroids—but there are adverse effects, particularly in people with diabetes. What are they?

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
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VIDEO: As biosimilars arrive in U.S., treatment questions arise

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MAUI, HAWAII – There’s been fairly brisk uptake of biosimilar infliximab in Europe, both for new patients and as a possible switch from Remicade.

That biosimilar infliximab, Remsima, was submitted for U.S. approval in 2014, and a Food and Drug Administration advisory panel recently recommended approval of a biosimilar for filgrastim (Neupogen).

The agents are in the vanguard of what is sure to be an expanding market in the United States as biologics come off patent. Additional infliximab replacements are in the works, as well as biosimilars for etanercept, adalimumab, rituximab, and others.

For rheumatologists, that could mean less expensive treatments for patients, but it’s also likely to make treatment more complicated. Given the complexity of the molecules, the differences between biosimilars and familiar brands could be a bit more marked than those between small-molecule generics and their branded counterparts.

In a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Arthur F. Kavanaugh, a rheumatology professor at the University of California, San Diego, outlined the latest developments and shared his thoughts on the rapidly evolving field.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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MAUI, HAWAII – There’s been fairly brisk uptake of biosimilar infliximab in Europe, both for new patients and as a possible switch from Remicade.

That biosimilar infliximab, Remsima, was submitted for U.S. approval in 2014, and a Food and Drug Administration advisory panel recently recommended approval of a biosimilar for filgrastim (Neupogen).

The agents are in the vanguard of what is sure to be an expanding market in the United States as biologics come off patent. Additional infliximab replacements are in the works, as well as biosimilars for etanercept, adalimumab, rituximab, and others.

For rheumatologists, that could mean less expensive treatments for patients, but it’s also likely to make treatment more complicated. Given the complexity of the molecules, the differences between biosimilars and familiar brands could be a bit more marked than those between small-molecule generics and their branded counterparts.

In a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Arthur F. Kavanaugh, a rheumatology professor at the University of California, San Diego, outlined the latest developments and shared his thoughts on the rapidly evolving field.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

MAUI, HAWAII – There’s been fairly brisk uptake of biosimilar infliximab in Europe, both for new patients and as a possible switch from Remicade.

That biosimilar infliximab, Remsima, was submitted for U.S. approval in 2014, and a Food and Drug Administration advisory panel recently recommended approval of a biosimilar for filgrastim (Neupogen).

The agents are in the vanguard of what is sure to be an expanding market in the United States as biologics come off patent. Additional infliximab replacements are in the works, as well as biosimilars for etanercept, adalimumab, rituximab, and others.

For rheumatologists, that could mean less expensive treatments for patients, but it’s also likely to make treatment more complicated. Given the complexity of the molecules, the differences between biosimilars and familiar brands could be a bit more marked than those between small-molecule generics and their branded counterparts.

In a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Arthur F. Kavanaugh, a rheumatology professor at the University of California, San Diego, outlined the latest developments and shared his thoughts on the rapidly evolving field.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

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VIDEO: Many stroke patients may miss out on clot-retrieval options

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VIDEO: Many stroke patients may miss out on clot-retrieval options

NASHVILLE, TENN. – A 1 million–patient analysis of the Get With the Guidelines database found striking improvements in outcomes after ischemic stroke.

Despite the proven benefits of new-generation clot-retrieval devices, however, only about 2% of such stroke patients undergo endovascular therapy.

In a video interview at the International Stroke Conference, Dr. Bijoy Menon of the department of clinical neurosciences at the University of Calgary (Alta.), who presented the findings at the conference, discussed this apparent clinical paradox.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

Dr. Menon’s study echoes findings of the landmark Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial, which found dramatically improved stroke outcomes after endovascular therapy.

But the benefits of such treatment should never outweigh the need for thoroughly screening patients and carefully considering their recovery prospects, Dr. Michael Hill, professor of neurology at the University of Calgary and primary investigator on the ESCAPE study, cautioned in another video interview at the meeting.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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NASHVILLE, TENN. – A 1 million–patient analysis of the Get With the Guidelines database found striking improvements in outcomes after ischemic stroke.

Despite the proven benefits of new-generation clot-retrieval devices, however, only about 2% of such stroke patients undergo endovascular therapy.

In a video interview at the International Stroke Conference, Dr. Bijoy Menon of the department of clinical neurosciences at the University of Calgary (Alta.), who presented the findings at the conference, discussed this apparent clinical paradox.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

Dr. Menon’s study echoes findings of the landmark Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial, which found dramatically improved stroke outcomes after endovascular therapy.

But the benefits of such treatment should never outweigh the need for thoroughly screening patients and carefully considering their recovery prospects, Dr. Michael Hill, professor of neurology at the University of Calgary and primary investigator on the ESCAPE study, cautioned in another video interview at the meeting.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

On Twitter @alz_gal

NASHVILLE, TENN. – A 1 million–patient analysis of the Get With the Guidelines database found striking improvements in outcomes after ischemic stroke.

Despite the proven benefits of new-generation clot-retrieval devices, however, only about 2% of such stroke patients undergo endovascular therapy.

In a video interview at the International Stroke Conference, Dr. Bijoy Menon of the department of clinical neurosciences at the University of Calgary (Alta.), who presented the findings at the conference, discussed this apparent clinical paradox.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

Dr. Menon’s study echoes findings of the landmark Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial, which found dramatically improved stroke outcomes after endovascular therapy.

But the benefits of such treatment should never outweigh the need for thoroughly screening patients and carefully considering their recovery prospects, Dr. Michael Hill, professor of neurology at the University of Calgary and primary investigator on the ESCAPE study, cautioned in another video interview at the meeting.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

On Twitter @alz_gal

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VIDEO: Biologics slowly taming metastatic melanoma

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MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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VIDEO: Varenicline may help smokers quit gradually

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Is it all or nothing when it comes to quitting smoking?

For many smokers, there may be another approach: A new study showed that a 24-week course of varenicline boosted quit rates among smokers who preferred to gradually reduce their cigarette use (JAMA 2015;313:687-94). That behavioral health reduction strategy may offer 14 million smokers an alternative route to quitting, noted study author Dr. Jon O. Ebbert of the Mayo Clinic, Rochester, Minn.

In a video interview, Dr. Ebbert discusses the strategy and its benefits.

Dr. Ebbert reported receiving grants from Pfizer, JHP Pharmaceuticals, and Orexigen, as well as personal fees from GlaxoSmithKline.

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Is it all or nothing when it comes to quitting smoking?

For many smokers, there may be another approach: A new study showed that a 24-week course of varenicline boosted quit rates among smokers who preferred to gradually reduce their cigarette use (JAMA 2015;313:687-94). That behavioral health reduction strategy may offer 14 million smokers an alternative route to quitting, noted study author Dr. Jon O. Ebbert of the Mayo Clinic, Rochester, Minn.

In a video interview, Dr. Ebbert discusses the strategy and its benefits.

Dr. Ebbert reported receiving grants from Pfizer, JHP Pharmaceuticals, and Orexigen, as well as personal fees from GlaxoSmithKline.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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Is it all or nothing when it comes to quitting smoking?

For many smokers, there may be another approach: A new study showed that a 24-week course of varenicline boosted quit rates among smokers who preferred to gradually reduce their cigarette use (JAMA 2015;313:687-94). That behavioral health reduction strategy may offer 14 million smokers an alternative route to quitting, noted study author Dr. Jon O. Ebbert of the Mayo Clinic, Rochester, Minn.

In a video interview, Dr. Ebbert discusses the strategy and its benefits.

Dr. Ebbert reported receiving grants from Pfizer, JHP Pharmaceuticals, and Orexigen, as well as personal fees from GlaxoSmithKline.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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VIDEO: Varenicline may help smokers quit gradually
Display Headline
VIDEO: Varenicline may help smokers quit gradually
Legacy Keywords
smoking, smoking cessation, varenicline
Legacy Keywords
smoking, smoking cessation, varenicline
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FROM JAMA

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