Safety of Varenicline Among Smokers Enrolled in the Lung HIV Study

Ferketich, Amy K.; Diaz, Philip T.; Browning, Kristine K.; Lü, Bo; Koletar, Susan L.; Reynolds, Nancy; Wewers, Mary Ellen

doi:10.1093/ntr/nts121

Cited by 41 publications

(29 citation statements)

References 38 publications

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“…At 3-month posttreatment, more participants in the varenicline condition were abstinent (25.6%) than were NRT-treated participants (11.8%). Ferketich et al 63 reported similar adverse events for varenicline, as well as specific adverse effects for NRT (including rash around patch site, nausea, vivid dreams, and insomnia). These authors also noted a single case of suicidal ideation that resolved after discontinuation of varenicline, and one case of myocardial infarction in a patient receiving NRT.…”

Section: Medication Treatmentsmentioning

confidence: 85%

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Smoking Cessation for People Living With HIV/AIDS: A Literature Review and Synthesis

Ledgerwood

Yskes

2016

NICTOB

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Introduction: People living with HIV/AIDS (PLWHA) are more likely to smoke cigarettes than are individuals in the general population. The health implications of tobacco use are substantially more dire among PLWHA than among otherwise healthy smokers, including higher rates of various cancers, cardiovascular disease, inflammation, and lung infections. Efficacious behavioral and medication treatments for treating nicotine dependence have rarely been investigated in PLWHA. Methods: We present a review of studies examining the efficacy of smoking cessation interventions. Results and Conclusions:The literature reveals some limited evidence for the efficacy of behavioral interventions. However, the research literature on these interventions is sparse and the efficacy findings are mixed. Studies exploring the use of mobile technologies for reducing treatment barriers are becoming more prevalent. Few published trials have directly examined the efficacy of pharmacological smoking cessation interventions among PLWHA. Specific gaps in the treatment literature are discussed in detail, and a strategy is presented for developing a greater understanding of factors that contribute to the efficacy of smoking cessation among PLWHA. Implications: This paper provides the most comprehensive review to date on smoking cessation intervention research conducted with PLWHA. It also discusses specific gaps in the literature that should be a priority for future research.

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Section: Medication Treatmentsmentioning

confidence: 85%

“…63 Participants in this study were encouraged to take varenicline but were offered NRT if they had contraindications for or preferred not to take this medication. At 3-month posttreatment, more participants in the varenicline condition were abstinent (25.6%) than were NRT-treated participants (11.8%).…”

Section: Medication Treatmentsmentioning

confidence: 99%

Smoking Cessation for People Living With HIV/AIDS: A Literature Review and Synthesis

Ledgerwood

Yskes

2016

NICTOB

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“…A recent preliminary non-randomized 12-week study in which all participants received telephone counseling and either varenicline or nicotine replacement therapy found that varenicline was associated with a greater odds of abstinence compared with nicotine replacement therapy. Adverse events associated with varenicline included nausea, sleep problems and mood disturbances and one person reported suicidal ideation; this did not vary based on whether patients were receiving antiretroviral therapy[54]. Results from a separate drug-company sponsored, multi-center open label pilot trial found that these adverse events were common, with 17% discontinuing the medication.…”

Section: Tobaccomentioning

confidence: 99%

Substance use in older HIV-infected patients

Edelman¹,

Tetrault²,

Fiellin³

2014

Current Opinion in HIV and AIDS

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Purpose of the Review Substance use may persist throughout the life course and has a substantial impact on health outcomes globally. As HIV-infected individuals are disproportionately impacted by substance use and living longer, it is critical that providers and researchers alike understand the impact of substance use on older, HIV-infected patients and potential treatment options. To this end, we conducted a review of the literature focusing on the most commonly used substances to outline the epidemiology, health consequences, treatment options and latest research relevant to older, HIV-infected patients. Recent Findings Substance use impacts older, HIV-infected patients with regards to HIV-related and non-HIV related outcomes. Counseling strategies are available for marijuana and stimulant use disorders. Brief counseling is useful alongside medications for alcohol, tobacco and opioid use disorders. Many medications for alcohol, tobacco, and opioid use disorders are safe in the setting of antiretroviral therapy. Unfortunately, few interventions targeting substance use in older, HIV-infected patients have been developed and evaluated. Summary As older, HIV-infected patients continue to experience substance use and its related health consequences, there will be a growing need for the development of safe and effective interventions which address the complex needs of this population.

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“…[72] There are several small trials on smoking cessation in the context of HIV that have concluded that it is an important and effective intervention. [72][73][74] Smoking and nicotine are known to induce hepatic enzymes, [75,76] but not those metabolising common antiretrovirals (ARVs). Enzyme inhibition/induction by ARVs such as lopinavir-ritonavir may increase or reduce serum concentrations of bupropion and should be used with caution.…”

Section: Hiv/antiretroviral Therapymentioning

confidence: 99%

“…[74] Varenicline is not metabolised by the liver, thus drug-drug interactions should not occur, but common side-effects such as nausea may interfere with ARV compliance. [73] …”

Section: Hiv/antiretroviral Therapymentioning

confidence: 99%