Varenicline for long term smoking cessation in patients with COPD

Zenteno, Rafael J. Hernández; Lara, Danitza Fernández; Venegas, Alejandra Ramírez; Sansores, Raúl H; Pineda, Justino Regalado; Trujillo, Fernando Flores; Padilla, José Rogelio Pérez; Matera, MG; Cazzola, Mario

doi:10.1016/j.pupt.2018.11.001

Cited by 10 publications

(12 citation statements)

References 18 publications

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“…Among all the participants, the 9-12 weeks sustained smoking cessation rate of varenicline was 49.1%, which was lower than an observational study of Hernandez Zenteno et al (61.2%), 20 and higher than the RCT of Carroll et al (42.3%). 21 The smoking cessation rate of bupropion was 35.7%, which was higher than the result of an RCT by Tashkin et al (28.0%).…”

Section: Discussioncontrasting

confidence: 59%

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Efficacy of varenicline or bupropion and its association with nicotine metabolite ratio among smokers with COPD

Qin,

Liu,

Cheng

et al. 2024

Respirology

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Background and objectiveNicotine metabolic ratio (NMR) has been associated with nicotine metabolism and smoking characteristics. However, there are few studies on the potential association between NMR and smoking cessation efficacy in smokers with chronic obstructive pulmonary disease (COPD) in China or elsewhere.MethodsThis study was a stratified block randomized controlled trial for smoking cessation in Chinese smokers with COPD. NMR was used as a stratification factor; slow metabolizers were defined as those with NMR <0.31, and normal metabolizers as those with NMR ≥0.31. Participants were randomly assigned to the varenicline or bupropion group. Follow‐up visits were conducted at 1, 2, 4, 6, 9, 12 and 24 weeks.ResultsTwo hundred twenty‐four participants were recruited and analysed from February 2019 to June 2022. In normal metabolizers, the 9–12 weeks continuous abstinence rate of varenicline (43.1%) was higher than in bupropion (23.5%) (OR = 2.47, 95% CI 1.05–5.78, p = 0.038). There was no significant difference in abstinence rates between treatment groups in slow metabolizers (54.1% vs. 45.9%, OR = 1.39, 95% CI 0.68–2.83, p = 0.366). For slow metabolizers, the total score of side effects in the varenicline group was significantly higher than the bupropion group (p = 0.048), while there was no significant difference in side effects between groups for normal metabolizers (p = 0.360).ConclusionVarenicline showed better efficacy than bupropion in normal metabolizers, and bupropion showed equivalent efficacy in slow metabolizers with less side effects. According to our study, NMR provides a better justification for both scientific research and tailoring optimal pharmacotherapy for smoking cessation among smokers in COPD.image

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Section: Discussioncontrasting

confidence: 59%

“…The sample size calculation was based on the previous study. 9–12 weeks continuous abstinence rates of varenicline were predicted as about 50%, 20,21 and about 30% for bupropion 14,22 . An allocation of 1:1 was employed with 80% power level and 5% two‐sided significance level.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of varenicline or bupropion and its association with nicotine metabolite ratio among smokers with COPD

Qin,

Liu,

Cheng

et al. 2024

Respirology

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“…PWID may be increasingly susceptible to the effects of OLD because of substance use compared with other populations of PWH. In the general population, maintenance inhaler therapy and smoking cessation interventions have shown promising results in limiting the morbidity and mortality because of COPD, a primary component of OLD [37–40]. In order to understand the potential of interventions to reduce mortality among PWH, the relationship between OLD and mortality must first be clarified among PWH.…”

Section: Discussionmentioning

confidence: 99%

Incident obstructive lung disease and mortality among people with HIV and a history of injecting drugs

Kalmin

Westreich²,

Drummond

et al. 2021

Aids

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Objective: People with HIV (PWH) experience increased prevalence of obstructive lung disease (OLD), regardless of greater observed smoking behaviors. We investigated whether the effect of incident OLD on mortality differed by HIV and HIV viral suppression among persons who inject drugs (PWID) and report smoking history.Design: ALIVE is a longitudinal, observational cohort study of HIV-positive and seronegative PWID. This analysis included participants who had at least one spirometry measure to assess OLD between 2007 and 2016, excluding those who never smoked (5%, n ¼ 62) or had baseline OLD (17%, n ¼ 269).Methods: Incident OLD occurred when the first prebronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) less than 0.70 during followup. The effect of incident OLD on all-cause mortality was estimated in PWH and seronegative participants using inverse-probability-of-treatment-weighted marginal structural models controlling for baseline (age, race, sex, calendar year, smoking pack-years) and time-varying (smoking intensity, viral suppression, and calendar time) confounders.Results: Among 1204 participants, 269 (22.3%) and 157 (13.0%) experienced incident OLD and death, respectively, over a median of five person-years of follow-up. There was no effect of OLD on mortality among seronegative participants [hazard ratio ¼ 0.84, 95% confidence interval (CI): 0.47-1.48]; however, PWH diagnosed with OLD experienced an increased mortality risk (hazard ratio ¼ 1.71, 95% CI: 1.04-2.80) during follow-up. HIV viral suppression did not confound or modify the effect of OLD on mortality among PWH. Conclusion:There was an apparent effect of OLD on all-cause mortality irrespective of viral suppression among PWH but not among seronegative persons, after accounting for baseline and time-varying confounders. These results highlight the need for enhanced screening and management of OLD among PWH.

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“…The outcome measures were: number of cigarettes and CO level over the treatment period up to 3 months. A recent trial measured the abstinence rate after 12 months of starting varenicline treatment 26 . In the present meta-analysis, the reported prolonged abstinence rates were measured during the last 4 weeks of starting the treatment, which may underestimate the effect of topiramate, and we did not have a long follow-up period after the treatment weeks, except in one study 15 that had a 24-week follow-up without measuring outcomes.…”

Section: Discussionmentioning

confidence: 99%

Topiramate for smoking cessation: Systematic review and meta-analysis

Lotfy

Elsawah

Hassan

2020

Tob. Prev. Cessation

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INTRODUCTION Topiramate is an antiepileptic drug that has been used for many labeled and off-labeled indications. It may be useful in reducing withdrawal symptoms of various addictive agents such as alcohol, cocaine, cannabis and smoking. To date, some studies have examined the effectiveness of topiramate for smoking cessation. The present review aims to synthesize the results from those studies and determine topiramate effectiveness in smoking cessation. METHODS A comprehensive search was conducted in the databases: PubMed/ Medline, Cochrane, Egyptian Knowledge Bank, and Google Scholar. All clinical trials that examined the effect of topiramate, compared with the placebo, on smoking cessation rate were included. Statistical analysis using fixed effect models, heterogeneity and sensitivity analysis were conducted using RevMan 5.3. RESULTS Five trials met the inclusion criteria and were included in the metaanalysis. Topiramate non-significantly increased prolonged smoking abstinence rate (OR=1.19, 95% CI: 0.57-2.5) compared with the placebo. On the other hand, topiramate significantly increased the abstinence rate at weeks 4

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Varenicline for long term smoking cessation in patients with COPD

Cited by 10 publications

References 18 publications

Efficacy of varenicline or bupropion and its association with nicotine metabolite ratio among smokers with COPD

Efficacy of varenicline or bupropion and its association with nicotine metabolite ratio among smokers with COPD

Incident obstructive lung disease and mortality among people with HIV and a history of injecting drugs

Topiramate for smoking cessation: Systematic review and meta-analysis

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