One year quit rates similar for NRT and varenicline
Abstinence from smoking is greater after 12 weeks of varenicline treatment than after 10 weeks of nicotine replacement therapy (NRT), according to a study published online in Thorax (8 February). However, the difference in quit rates did not remain significant after one year.
The open label trial (funded by varenicline’s manufacturer Pfizer) involved 757 patients who smoked at least 15 cigarettes per day and was conducted in the UK, Belgium, France, the Netherlands and the US. It randomised participants to receive varenicline titrated up to 1mg twice daily for 12 weeks or NRT (21mg per day reducing to 7mg per day) for 10 weeks. Follow-up continued for 52 weeks.
A total of 746 participants were eligible for analysis, say the researchers. Self-reported abstinence rates (confirmed by exhaled carbon monoxide levels) during the last four weeks of treatment were 55.9 per cent for varenicline and 43.2 per cent for NRT (odds ratio 1.70, 95 per cent confidence interval 1.26–2.28;P<0.001).
However, at 52 weeks the difference in continuous abstinence rates was not significant (P=0.056), the figures being 26.1 per cent for varenicline (weeks 9–52) and 20.3 per cent for NRT (weeks 8–52).
The results also showed that varenicline reduced craving, withdrawal symptoms and smoking satisfaction compared with NRT (all P<0.001). The most frequent adverse effect was nausea, reported for 37.2 per cent of those taking varenicline and 9.7 per cent of those on NRT.
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