What question did this study set out to answer?

To evaluate whether combining varenicline with a nicotine patch, extending therapy duration from 12 to 24 weeks, or both increases long-term smoking cessation rates.

October 19, 2021JAMAOpen Access

Effects of Combined Varenicline With Nicotine Patch and of Extended Treatment Duration on Smoking Cessation

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Authors

TBTimothy B. BakerUniversity of Wisconsin–Madison MPMegan E. PiperUniversity of Wisconsin–Madison SSStevens S. SmithRutgers, The State University of New Jersey

Discussion

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Implication

Randomized double-blind trial finds no cessation benefit from adding a nicotine patch to varenicline or extending treatment, indicating standard monotherapy is optimal.

Key Points

To evaluate whether combining varenicline with a nicotine patch, extending therapy duration from 12 to 24 weeks, or both increases long-term smoking cessation rates.
Double-blind, 2 × 2 factorial randomized clinical trial conducted at 2 clinics in Wisconsin from 2017 to 2020 among 1251 adults smoking ≥5 cigarettes/day (NCT03176784).
Participants received cessation counseling and were randomized to 12-week varenicline monotherapy (n=315), 12-week varenicline plus nicotine patch (n=314), 24-week varenicline monotherapy (n=311), or 24-week varenicline plus nicotine patch (n=311).
The primary outcome was carbon monoxide-confirmed self-reported 7-day point prevalence abstinence at 52 weeks.
For 24-week versus 12-week treatment duration, the primary outcome occurred in 24.8% (154/622) versus 24.3% (153/629), respectively (risk difference, -0.4% [95% CI, -5.2% to 4.3%]; OR, 1.01 [95% CI, 0.89 to 1.15]).
For varenicline combination therapy versus varenicline monotherapy, abstinence occurred in 24.3% (152/625) versus 24.8% (155/626), respectively (risk difference, 0.4% [95% CI, -4.3% to 5.2%]; OR, 0.99 [95% CI, 0.87 to 1.12]; interaction OR, 1.03 [95% CI, 0.91 to 1.17]; P = .66).
Across all 4 groups, nausea occurred in 24.0% to 30.9% of participants and insomnia occurred in 24.4% to 30.5%.

Cite This Study

Baker et al. (2021) studied this question.

synapsesocial.com/papers/6a708b64fe4101aa97e03729 https://doi.org/10.1001/jama.2021.15333

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Implication

Randomized double-blind trial finds no cessation benefit from adding a nicotine patch to varenicline or extending treatment, indicating standard monotherapy is optimal.

Effects of Combined Varenicline With Nicotine Patch and of Extended Treatment Duration on Smoking Cessation

Discussion

Member takes

Implication

Key Points

Cite This Study

Effects of Combined Varenicline With Nicotine Patch and of Extended Treatment Duration on Smoking Cessation

Discussion

Member takes

Implication

Key Points

Cite This Study

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