Varenicline Effective in Smoking Cessation for Smokers With Chronic Diseases: Presented at ERS

Varenicline Effective in Smoking Cessation for Smokers With Chronic Diseases: Presented at ERS

By Chris Berrie

BERLIN -- October 8, 2008 -- Varenicline is an effective smoking cessation aid in smokers with chronic obstructive pulmonary disease (COPD), asthma, or cardiovascular disease (CVD), according to a comparative study presented here at the European Respiratory Society (ERS) 18th Annual Congress.

Smoking cessation is the most cost-effective intervention for patients with COPD and declining forced expiratory volume in first second (FEV₁), although the role for pharmacological intervention remains to be determined.

In a presentation on October 6, principal investigator Dimitrios Michailidis, MD, Smoking Cessation Centre, Pulmonary and Critical Care Department, Athens Medical School, Evgenidion Hospital, Athens, Greece, indicated that while varenicline, the alpha₄beta₂-nicotinic acetylcholine receptor partial agonist, represents a new treatment for smoking cessation, "there are not so many references in the literature for varenicline in smokers with chronic disease."

Thus, he added that it is important to compare varenicline and nicotine-replacement therapy (NRT) in these populations.

For their study, Dr. Michailidis and colleagues enrolled 223 healthy smokers (mean age, 44.8 years; male, 50.7%), 48 patients with COPD (58.3 years; male, 45.8%), 47 with asthma (42.4 years; male, 31.9%), and 97 patients with CVD (52.5 years; male, 59.8%).

These patients were randomised, 219 to NRT and 196 to varenicline for 12 weeks. For treatment according to disease (NRT vs varenicline), there were healthy smokers (n = 103 vs 120), COPD (n = 26 vs 22), asthma (n = 32 vs 15), and CVD (n = 58 vs 39). NRT was administered every 16 hours

All patients followed the same intense programme and follow-up, with behavioural support combined with the respective pharmacological treatments. This programme included weekly clinic visits for the first month, then every 3 weeks to the end of treatment, and then once every 3 months.

The NRT dosing was 15 mg for 8 weeks, 10 mg for 2 weeks, and 5 mg for 2 weeks. Varenicline dosing was administered once daily at 0.5 mg on days 1 to 3, 0.5 mg morning and night on days 4 to 7, and 1 mg in the morning and night on day 8 to end of treatment.

Good compliance with the treatment programmes was reported for 57.0% on NRT and 79.6% taking varenicline.

After 12 weeks of treatment, the benefits of NRT and varenicline were, respectively, smoking abstinence (65.9% and 75.3%), smoking reduction (18.0% and 13.5%), and cessation failure (16.1% and 11.2%).

Rates of continuous abstinence after 12 weeks across treatments for NRT versus varenicline were 65% versus 72% for healthy smokers, 62% versus 78% in patients with COPD, 61% versus 90% in patients with asthma, and 61% versus 77% in patients with CVD.

Dr. Michailidis stressed that varenicline is very effective as a part of smoking cessation treatment in smokers with COPD, asthma, or CVD and that it has no serious adverse effects. However, he stressed the need for regular patient follow-up for successful therapy.

He also noted that, according to the time courses for smoking cessation across the diseases, the healthy patients and those with CVD initially saw very low cessation rates (7 weeks, 95% and 96%, respectively), while those with COPD or asthma showed much increased initial cessation rates (7 weeks, 75% each). These results further emphasise the need for an intensive intervention programme, he said.

[Presentation title: Comparison of Effectiveness of Varenicline and NRTs in Smoking Cessation in Patients With Chronic Diseases. Abstract P2070]
dr.salam Bader

Thank you dear Dr. Salam Bader for your nice informations for more nice participations with my best wishes as well regards yours
Dr. Aljuraisy