Adjunctive varenicline treatment for smoking reduction in patients with schizophrenia: A randomized double-blind placebo-controlled trial

Jeon, Dong-Wook; Shim, Joo-Cheol; Kong, Bo-Geum; Moon, Jung-Joon; Seo, Young-Soo; Kim, Sungjin; Oh, Minkyung; Jung, Do-Un

doi:10.1016/j.schres.2016.08.016

Cited by 9 publications

(8 citation statements)

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“…Our four included RCTs were comprised of 239 participants at baseline; however, only 191 completed the study and follow-up. The DSM-IV confirmed only schizophrenia in only one study ( 43 ), while schizophrenia or schizoaffective disorder was present in the participants in the remaining studies ( 19 , 33 , 46 ). The participants' mean age ranged from 40 to 43, and most of patients were male.…”

Section: Resultsmentioning

confidence: 92%

“…Performance, detection, attrition, and reporting bias were low in all studies. Regarding allocation concealment, there was an unclear risk of bias in two studies ( 19 , 46 ) while there was only a low risk in the remaining two ( 33 , 43 ). The risk of bias in the studies is characterized in Figure 2 .…”

Section: Resultsmentioning

confidence: 98%

“…In one of the studies, researchers did not indicate the age or gender of included participants ( 19 ). The treatment duration was 12 weeks in two studies ( 19 , 33 ) and only 8 weeks in the two remaining ( 43 , 46 ). The characteristics of the studies are detailed in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…However, the results of this metanalysis run counter to numerous studies that have found varenicline to be an effective, safe, and well-tolerated treatment for smoking cessation in schizophrenic patients ( 3 , 33 , 41 , 42 ). Because of these positive findings as well as a new study on this topic ( 43 ), we sought to synthesize previous findings and examine the overall effect of varenicline on smoking cessation among patients with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Varenicline for Smoking Cessation in Schizophrenia: A Meta-Analysis

et al. 2018

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Objective: Smoking represents a major public health problem among patients with schizophrenia. To this end, some studies have investigated the efficacy of varenicline for facilitating smoking cessation in schizophrenia patients. The present review seeks to synthesize the results of these studies as well as document the reported side effects of using this medication.Methods: An electronic search was performed using five major databases: PubMed, Scopus, EMBASE, Web of Science, and Cochrane Library. Included in the current analysis were randomized clinical trials (RCTs) that have investigated the effect of varenicline in promoting smoking cessation in patients with schizophrenia. Risk of bias among included RCTs was assessed using the Cochrane Collaboration's quality assessment tool.Results: Among the 828 screened articles, only four RCTs, which involved 239 participants, were eligible for meta-analysis. In patients with schizophrenia, varenicline treatment when compared to placebo significantly reduced the number of cigarettes consumed per day [SMD (95% CI) = 0.89(0.57–1.22)] and expired carbon monoxide levels [SMD (95% CI) = 0.50 (0.06–0.94)] respectively.Conclusion: Despite a limited number of studies included in the meta-analysis, our results suggest that varenicline is an effective and safe drug to assist smoking cessation in patients with schizophrenia. Future large-scale well-designed RCTs are required to validate these findings.

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Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Varenicline for Smoking Cessation in Schizophrenia: A Meta-Analysis

et al. 2018

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“…Исследования цитизина проводили в Кыргызстане [107], Польше [112] и Новой Зеландии [108]. Исследования варениклина проводили в США [7,17,35,54,73,76], Японии [72,104], США и Канаде [116], Дании [99], Греции [50], Тайване и Корее [102], Китае, Сингапуре и Тайване [53], а также в более чем трех странах одновременно [4,6,11,36,83,84,98] Niaura (2008), где день отказа от курения находился в пределах 8-35-го дня терапии [73]. В исследовании Niaura (2008) после недели эскалации дозы участники могли менять дозу варениклина с целью уменьшения нежелательных явлений в пределах от 0,5 до 2,0 мг в день, такой стандартный курс лечения продолжали до 84-го дня [73].…”

Section: Introductionunclassified

Network meta-analysis: a comparison of effectiveness and safety of partial agonists of nicotinic acetylcholine receptors varenicline and cytisine for smoking cessation

Radchenko

Владимировна²,

Sykhovskaya

et al. 2018

Rev Clin Pharm Drug Ther

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Background. Partial agonists of α4b2 nicotinic acetylcholine receptors are the most effective treatment strategy for tobacco smoking cessation. They are able to alleviate withdrawal symptoms and to reduce smoking satisfaction. The aim of this study was to review the efficacy and safety of nicotinic receptor partial agonists varenicline and cytisine, for smoking cessation. Methods. A search for randomized controlled trials was done using the terms (“cytisine”, “tabex”, “varenicline” or 'partial agonists of nicotinic receptors’) in MEDLINE, EMBASE, eLibrary in May 2018. Types of participants, the doses and duration of the treatments, efficacy and safety parameters, quality of randomization and blinding procedures were evaluated. Bayesian network meta-analysis was performed. Results. Cytisine overcame placebo in the 12, 24 and 52 weeks of therapy with the following odds ratios (ORs) for abstinence: 3.3 (95% CrI 1.8–5.8), 3.9 (2.4–6.7), 3.8 (CrI 1.3–11,9) accordingly. Varenicline in 2 mg/day dose overcame placebo in the 12, 24 and 52 weeks of therapy with the ORs: 4.0 (3.3–4.7), 3.1 (2.5–3.7), 2.9 (2.2–4.1) accor dingly. Varenicline in 1 mg/day dose overcame placebo in 12 and 52 weeks of therapy, the ORs were 3.0 (2.0–4.7) and 2.3 (1.3–4.4) accordingly. Varenicline in 0.5 mg/day dose overcame placebo in 12 weeks of therapy only with the OR 2.4 (1.3–4.4). Cytisine and varenicline 2 mg/day were associated with more gastrointestinal disturbances than placebo with the ORs 6.2 (2.1–22.8) and 2.4 (2.0–2.8) accordingly. Cytisine and varenicline 2 mg/day were associated with more psychiatric problems than placebo with ORs 5.2 (1.9–15.1) and 1.6 (1.3–1.9) accordingly. There was no difference in serious adverse events between the investigated drugs and placebo: OR for cytisine was 2.4 (0.8–6.8), varenicline 0.5 mg/day – 2.0 (0.5–6.6), varenicline 1.0 mg/day – 1.0 (0.3–2.7), varenicline 2 mg/day – 1.0 (0.7–1.4). Conclusion. Cytisine was proved to be as effective and safe aid for smoking cessation as varenicline.

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Smoking reduction interventions for smoking cessation

Lindson

Klemperer

Hong

et al. 2019

Cochrane Database of Systematic Reviews

100

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Cochrane Database of Systematic Reviews Main results We identified 51 trials with 22,509 participants. Most recruited adults from the community using media or local advertising. People enrolled in the studies typically smoked an average of 23 cigarettes a day. We judged 18 of the studies to be at high risk of bias, but restricting the analysis only to the five studies at low or to the 28 studies at unclear risk of bias did not significantly alter results. We identified very low-certainty evidence, limited by risk of bias, inconsistency and imprecision, comparing the effect of reduction-toquit interventions with no treatment on cessation rates (RR 1.74, 95% CI 0.90 to 3.38; I 2 = 45%; 6 studies, 1599 participants). However, when comparing reduction-to-quit interventions with abrupt quitting (standard care) we found evidence that neither approach resulted in superior quit rates (RR 1. 01, 95% CI 0.87 to 1.17; I 2 = 29%; 22 studies, 9219 participants). We judged this estimate to be of moderate certainty, due to imprecision. Subgroup analysis provided some evidence (P = 0.01, I 2 = 77%) that reduction-to-quit interventions may result in more favourable quit rates than abrupt quitting if varenicline is used as a reduction aid. Our analysis comparing reduction using pharmacotherapy with reduction alone found low-certainty evidence, limited by inconsistency and imprecision, that reduction aided by pharmacotherapy resulted in higher quit rates (RR 1. 68, 95% CI 1.09 to 2.58; I 2 = 78%; 11 studies, 8636 participants). However, a significant subgroup analysis (P < 0.001, I 2 = 80% for subgroup differences) suggests that this may only be true when fast-acting NRT or varenicline are used (both moderate-certainty evidence) and not when nicotine patch, combination NRT or bupropion are used as an aid (all low-or very low-quality evidence). More evidence is likely to change the interpretation of the latter effects. Although there was some evidence from within-study comparisons that behavioural support for reduction to quit resulted in higher quit rates than self-help resources alone, the relative efficacy of various other characteristics of reduction-to-quit interventions investigated through within-and between-study comparisons did not provide any evidence that they enhanced the success of reduction-to-quit interventions. Pre-quit AEs, SAEs and nicotine withdrawal symptoms were measured variably and infrequently across studies. There was some evidence that AEs occurred more frequently in studies that compared reduction using pharmacotherapy versus no pharmacotherapy; however, the AEs reported were mild and usual symptoms associated with NRT use. There was no clear evidence that the number of people reporting SAEs, or changes in withdrawal symptoms, differed between trial arms. Authors' conclusions There is moderate-certainty evidence that neither reduction-to-quit nor abrupt quitting interventions result in superior long-term quit rates when compared with one another. Evidence comparing the efficacy of reduction-to-quit interve...

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Adjunctive varenicline treatment for smoking reduction in patients with schizophrenia: A randomized double-blind placebo-controlled trial

Cited by 9 publications

References 45 publications

Efficacy and Safety of Varenicline for Smoking Cessation in Schizophrenia: A Meta-Analysis

Efficacy and Safety of Varenicline for Smoking Cessation in Schizophrenia: A Meta-Analysis

Network meta-analysis: a comparison of effectiveness and safety of partial agonists of nicotinic acetylcholine receptors varenicline and cytisine for smoking cessation

Smoking reduction interventions for smoking cessation

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