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Varenicline Combo, Extension No Better for Quitting Smoking

Combining varenicline with nicotine patch, extending treatment from 12 to 24 weeks did not increase smoking cessation rates

TUESDAY, Oct. 19, 2021 (HealthDay News) -- For adults smoking five cigarettes/day or more, smoking cessation rates do not differ for those treated with varenicline plus nicotine patch therapy compared with varenicline alone or for those treated with extended duration versus standard duration therapy, according to a study published in the Oct. 19 issue of the Journal of the American Medical Association.

Timothy B. Baker, Ph.D., from the University of Wisconsin in Madison, and colleagues compared combinations of varenicline plus the nicotine or placebo patch used for 12 weeks (standard duration) or 24 weeks (extended duration). A total of 1,251 adults who smoked five cigarettes/day or more were randomly assigned to varenicline monotherapy for 12 weeks, varenicline plus nicotine patch for 12 weeks, varenicline monotherapy for 24 weeks, or varenicline plus nicotine patch for 24 weeks (315, 314, 311, and 311 participants, respectively).

The researchers found that for the primary outcome of carbon monoxide-confirmed self-reported seven-day point prevalence abstinence at 52 weeks following the target quit day, there was no significant interaction between the two treatment factors of medication type and medication duration (odds ratio, 1.03; 95 percent confidence interval, 0.91 to 1.17; P = 0.66). The primary outcome occurred in 24.8 and 24.3 percent of patients randomly assigned to 24- versus 12-week treatment duration, respectively (odds ratio, 1.01; 95 percent confidence interval, 0.89 to 1.15), and in 24.3 and 24.8 percent of those randomly assigned to varenicline combination therapy versus monotherapy, respectively (odds ratio, 0.99; 95 percent confidence interval, 0.87 to 1.12).

"No subgroup of participants was identified for whom the effectiveness of the different treatments varied significantly," the authors write.

Pfizer supplied the study with free active and placebo varenicline.

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