Varenicline combined with NRT is better
The combination of varenicline and nicotine replacement therapy (NRT) was proven to be more effective than the usage of varenicline alone in achieving smoking cessation at 12 weeks and at six months, a recent study showed.
Varenicline acts as nicotine antagonist and partial agonist that might neutralize NRT in supporting smoking cessation. An investigation conducted by researchers in South Africa was designed to evaluate the efficacy and tolerability in combining varenicline with NRT.
The study encompassed 446 long-term adult smokers with a mean age of 46 and an estimated 21 years of smoking at seven centers in South Africa. They were investigated for 12 weeks with varenicline and NRT.
A 55 percent four-week abstinence rate was shown from the participants who underwent the combined therapy. On the other hand, varenicline-monotherapy only showed a 40-percent abstinence rate.
Furthermore, the subsequent 24-week abstinence rates were 49 percent and 33 percent, respectively. Both groups however experienced weight gain and mild adverse events.
For the participants who underwent the combination therapy, results showed that there was a greater incidence of nausea, sleep disturbance, skin reactions, constipation, and depression. Meanwhile, the group with varenicline alone reported side-effects of abnormal dreams and headaches.
The study conducted also revealed that tobacco abstinence was confirmed by exhaled carbon monoxide measurements at target quit date (TQD) and also at intervals thereafter up to 24 weeks.
Its primary end point was the four-week exhaled carbon monoxide. Its continuous abstinence rate was established for nine weeks up to 12 of treatment while secondary end points noted prevalence abstinence at six months. It has a continuous abstinence rate from weeks nine through 24 and some adverse events.
“Clinical use of varenicline and nicotine replacement together seems reasonable, and these results are encouraging,” Thomas L. Schwenk noted in his Journal Watch review.
He added, “However, before this combination becomes mainstream, this type of study should be repeated in other populations and with longer follow-up.” With a Journal Watch report
VitalSigns Issue 66 Vol. 3, August 1-31, 2014