21P - The efficacy of combination therapy with varenicline and bupropion for smoking cessation

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Cancer Aetiology, Epidemiology, Prevention
Lung and other Thoracic Tumours
Presenter Dexton Johns
Citation Annals of Oncology (2017) 28 (suppl_2): ii6-ii8. 10.1093/annonc/mdx087
Authors D.A. Johns
  • DM Wayanad Institute Of Medical Science, 682021 - Kalpetta/IN

Abstract

Background

Extended use of combined pharmacotherapies to treat tobacco dependence may increase smoking abstinence. The objective of this study was to evaluate smoking abstinence by using bupropion alone, varenicline alone and combination of both.

Methods

We conducted a randomized, prospective, double-blind, trial with 300 smokers enrolled. Group 1 bupropion alone (150 mg twice daily), group 2 varenicline alone (1 gm twice daily), group 3 varenicline + bupropion (1 gm twice daily+ 150 mg twice daily). The drugs were given for 12 weeks. Main outcome measures: The primary outcome was carbon monoxide-confirmed continuous abstinence rates (CAR) and the assessment of nicotine withdrawal symptoms. Nicotine dependence was assessed with the 6-item Fagerstrom Test for Nicotine Dependence scores ≥ 6 indicate high dependence. During the treatment phase, the Minnesota Nicotine Withdrawal Scale was used to assess withdrawal symptoms.

Results

Subjects in the group 1,2 and 3 (n = 100 each) were comparable in age, smoking history, number of daily smoked cigarettes, and nicotine dependence. After the treatment there was reduced cigarette cravings (17.5 ± 1.1vs 15 ±3 vs 13.1 ± 1) and total nicotine withdrawal symptoms (17.8 ± 4.3 vs 15.4 ± 5.1 vs13.2 ± 2.1) during the treatment period. As compared to B and VR monotherapy, VR+B produced significant increases in CAR at 6 months (OR, 1.63; CI, 1.10-2.20, OR, 1.52; CI, 1.00-2.30 and OR, 1.72; CI, 1.06-2.67, respectively); results were similar, but somewhat stronger, when 7PP was used at 10 weeks (OR, 1.69; CI, 1.05-2.53, OR, 1.57; CI, 1.03-2.41 and OR, 1.82; CI, 1.09-2.83, respectively)All medications were well tolerated, but participants in the VR groups experienced more fatigue, digestive symptoms (e.g., nausea, diarrhea), and sleep-related concerns (e.g., abnormal dreams, insomnia). The frequency of serious adverse events did not differ between groups.

Conclusions

Dual medication was found to enhance success in the early phases of quitting.

Clinical trial identification

REF/2017/03/013652

Legal entity responsible for the study

Abhilash Clinic

Funding

N/A

Disclosure

The author has declared no conflicts of interest.