Review Backs Varenicline for Smoking Cessation

JONATHAN GARDNER (London Bureau)

Family Practice news  Volume 37, Issue 7, Page 29 (1 April 2007)

Varenicline triples the likelihood that a smoker will quit, compared with placebo, according to a Cochrane Collaboration review.

The review of varenicline, a nicotine receptor agonist, based its findings on five randomized controlled trials that included more than 4,900 people, more than 2,400 of whom took varenicline (Cochrane Database Syst. Rev. 2007 Jan. 24 [Epub doi: 10.1002/14651858.CD006103.pub2]).

Findings were validated in all of the studies included in the meta-analysis by measuring exhaled carbon monoxide levels.

At 12 months, the pooled odds of the smokers taking varenicline were 3.22 times as great as those taking placebo to have continuously abstained from smoking, according to the reviewers, led by Kate Cahill, of the primary health care department at Oxford University (England). At 12 weeks, patients taking varenicline were 4.07 times as likely as those taking a placebo to have continuously abstained from smoking, and at 24 weeks, 3.53 times as likely, according to the reviewers.

The trials indicate that varenicline is effective, but the reviewers said more comparisons with other smoking-cessation strategies””such as nicotine replacement therapy””are needed.

Three studies compared varenicline to bupropion, an antidepressant. At 12 months, the smokers taking varenicline were 66% more likely to have abstained from smoking, according to the reviewers.

The number of smokers needed to treat with varenicline to achieve one more successful quitter is eight, compared with placebo. By comparison, nicotine replacement therapy requires 20 and bupropion 15.

All the varenicline studies meeting the reviewers’ inclusion criteria were funded by Pfizer Inc., which manufactures the medication under the brand name Chantix.