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Varenicline Treatment for Active Alcoholic Smokers

Primary Purpose

Smoking, Tobacco Dependence, Alcohol Dependence

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Varenicline
placebo
Sponsored by
Mayo Clinic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Smoking focused on measuring smoking, tobacco dependence, alcohol dependence

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Male or non-pregnant female cigarette smokers 18-years-of-age or older and reporting smoking at least an average of 10 cigarettes per day for the past year;
  2. Subject is alcohol dependence based on DSM IV criteria as assessed by the Mini-International Neuropsychiatric Interview (MINI) and the physician investigator;3
  3. Subject is currently drinking alcoholic beverages as assessed by the physician investigator;
  4. Subject is a female subject of non-childbearing potential or a female subject of childbearing potential - who is using contraceptives and has a negative pregnancy test result;
  5. Subject must be able to complete all the study visits;
  6. Subject has the ability to participate fully in all aspects of the study and keep scheduled appointments;
  7. Subject must be in good general health as determined by medical history, physical exam and physician investigator;
  8. Subject must provide written informed consent to participate in the study;

Exclusion Criteria:

  1. Subject is a female who is pregnant, lactating or likely to become pregnant during the trial and not willing to use an acceptable form of contraception during the medication phase, (for women of child-bearing potential, a pregnancy test will be performed prior to entry into the study and at the end of the medication phase);
  2. Subject has another household member in study;
  3. Known allergy to varenicline;
  4. Subject is currently (in previous 30 days) using other behavioral or pharmacologic tobacco cessation program (i.e., behavioral therapy, nicotine replacement therapy, clonidine, varenicline, bupropion SR, nortriptyline or doxepin) and unwilling or unable to discontinue use;
  5. Subject has an unstable medical condition as determined by the physician investigator;
  6. Subject describes having a medical history of: a) unstable angina; b) myocardial infarction within the past 3 months; c) coronary angioplasty or d) an untreated cardiac dysrhythmia;
  7. Subject has a personal history of renal failure or is on renal dialysis;
  8. Subject has a current moderate or severe depression as assessed by the Center for Epidemiologic Studies-Depression survey (CES-D) and physician investigator;
  9. Subject has, as defined by the Columbia Suicide Severity Rating Scale (C-SSRS) current non-specific suicidal thoughts, or have a lifetime history of a suicidal attempt (defined as "potentially self-injurious act committed with at least some wish to die, as a result of act");
  10. Subject has current (past 30 days) major depressive disorder or has a history of another psychiatric disorder such as psychosis or bipolar disorder;
  11. Subject currently uses of other tobacco products (i.e. pipe, cigar, smokeless tobacco) within the past 30 days;
  12. Subject currently has cancer [excluding non melanoma skin cancer] not in remission (cancer free for 5 years or more);
  13. Subject currently has Type 1 diabetes;
  14. Subject has untreated hypertension or baseline systolic blood pressure > 180 or diastolic > 100;
  15. Subject is currently on treatment with another investigational drug (within 30 days of study entry);

Sites / Locations

  • Mayo Clinic in Rochester
  • Franciscan Skemp Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Varenicline

Sugar Pil

Arm Description

varenicline 1.0 mg twice daily for 12 weeks

Varenicline look alike sugar pill twice daily for 12 weeks

Outcomes

Primary Outcome Measures

Prolonged Smoking Abstinence at End of 12 Weeks of Varenicline Treatment
Prolonged smoking abstinence will be identified by a negative response to the question, "Since 2 weeks after your TQD, have you smoked any tobacco, even a puff, for 7 consecutive days or at least once each week on 2 consecutive weeks?"

Secondary Outcome Measures

Prolonged Abstinence at 24 Weeks
Prolonged abstinence is identified by a negative response to the question, "Since 2 weeks after your TQD, have you smoked any tobacco, even a puff, for 7 consecutive days or at least once each week on 2 consecutive weeks?"
Heavy Drinking Days at End of Treatment
Heavy drinking is defined as 5 standard alcohol drinks or greater for men and 4 standard alcohol drinks or greater for women. The number of heavy drinking days per month was determined using the timeline follow-back method.

Full Information

First Posted
May 2, 2011
Last Updated
January 9, 2018
Sponsor
Mayo Clinic
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1. Study Identification

Unique Protocol Identification Number
NCT01347112
Brief Title
Varenicline Treatment for Active Alcoholic Smokers
Official Title
Varenicline Treatment for Active Alcoholic Smokers
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Completed
Study Start Date
June 2011 (undefined)
Primary Completion Date
January 2014 (Actual)
Study Completion Date
March 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Mayo Clinic

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Alcohol dependence is a significant and prevalent public health problem affecting approximately 4% of the U.S. adult population. Individuals with alcohol dependence actively seek treatment annually, and long-term alcohol abstinence varies from 40-60%. Because of the high smoking prevalence and trends toward heavier smoking, alcoholic smokers are at high risk for both morbidity and mortality related to alcohol consumption and tobacco dependence. Although several studies have evaluated pharmacotherapy for tobacco dependence in recovering alcoholic smokers, few have evaluated pharmacotherapy for tobacco dependence among currently drinking alcoholic smokers. Varenicline is the most effective medication currently available for treating tobacco dependence. While some randomized trials have included recovering alcoholics, active alcoholism has been an exclusion criteria for these trials. Thus, this proposal would be the first such clinical trial in currently drinking alcoholic smokers. In addition to helping smokers to stop smoking, varenicline has also been shown to reduce alcohol consumption in rats. The goal of this proposal is to explore the potential efficacy of varenicline for treating tobacco dependence and reducing drinking among alcohol dependent smokers. The investigators hypothesize that 12 weeks of treatment with varenicline, a partial nicotinic acetylcholine receptor agonist will be more effective than placebo in treating tobacco dependence and reducing nicotine withdrawal symptoms in currently drinking alcoholic smokers. The investigators will also explore whether varenicline has an effect on drinking behavior among currently drinking alcoholics. The investigators propose the following specific aims to test these hypotheses in 70 currently drinking alcoholic smokers recruited at the Mayo Clinic in Rochester, Minnesota.
Detailed Description
Seventy smokers who are currently alcohol dependent will be enrolled to this study. If found to be study eligible they will be randomized to either active varenicline or placebo for 12 weeks. During these two weeks, they will be seen either weekly or biweekly. At the end of treatment, they will be followed up for an addition 12 weeks. Their last study visit will be 6 months after randomization.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Smoking, Tobacco Dependence, Alcohol Dependence
Keywords
smoking, tobacco dependence, alcohol dependence

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
33 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Varenicline
Arm Type
Active Comparator
Arm Description
varenicline 1.0 mg twice daily for 12 weeks
Arm Title
Sugar Pil
Arm Type
Placebo Comparator
Arm Description
Varenicline look alike sugar pill twice daily for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Varenicline
Other Intervention Name(s)
chantix, champix, varenicline tartrate
Intervention Description
varenicline 1.0 mg dose, twice daily for 12 weeks
Intervention Type
Drug
Intervention Name(s)
placebo
Other Intervention Name(s)
sugar pill
Intervention Description
sugar pill twice daily for 12 weeks
Primary Outcome Measure Information:
Title
Prolonged Smoking Abstinence at End of 12 Weeks of Varenicline Treatment
Description
Prolonged smoking abstinence will be identified by a negative response to the question, "Since 2 weeks after your TQD, have you smoked any tobacco, even a puff, for 7 consecutive days or at least once each week on 2 consecutive weeks?"
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Prolonged Abstinence at 24 Weeks
Description
Prolonged abstinence is identified by a negative response to the question, "Since 2 weeks after your TQD, have you smoked any tobacco, even a puff, for 7 consecutive days or at least once each week on 2 consecutive weeks?"
Time Frame
week 24
Title
Heavy Drinking Days at End of Treatment
Description
Heavy drinking is defined as 5 standard alcohol drinks or greater for men and 4 standard alcohol drinks or greater for women. The number of heavy drinking days per month was determined using the timeline follow-back method.
Time Frame
week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or non-pregnant female cigarette smokers 18-years-of-age or older and reporting smoking at least an average of 10 cigarettes per day for the past year; Subject is alcohol dependence based on DSM IV criteria as assessed by the Mini-International Neuropsychiatric Interview (MINI) and the physician investigator;3 Subject is currently drinking alcoholic beverages as assessed by the physician investigator; Subject is a female subject of non-childbearing potential or a female subject of childbearing potential - who is using contraceptives and has a negative pregnancy test result; Subject must be able to complete all the study visits; Subject has the ability to participate fully in all aspects of the study and keep scheduled appointments; Subject must be in good general health as determined by medical history, physical exam and physician investigator; Subject must provide written informed consent to participate in the study; Exclusion Criteria: Subject is a female who is pregnant, lactating or likely to become pregnant during the trial and not willing to use an acceptable form of contraception during the medication phase, (for women of child-bearing potential, a pregnancy test will be performed prior to entry into the study and at the end of the medication phase); Subject has another household member in study; Known allergy to varenicline; Subject is currently (in previous 30 days) using other behavioral or pharmacologic tobacco cessation program (i.e., behavioral therapy, nicotine replacement therapy, clonidine, varenicline, bupropion SR, nortriptyline or doxepin) and unwilling or unable to discontinue use; Subject has an unstable medical condition as determined by the physician investigator; Subject describes having a medical history of: a) unstable angina; b) myocardial infarction within the past 3 months; c) coronary angioplasty or d) an untreated cardiac dysrhythmia; Subject has a personal history of renal failure or is on renal dialysis; Subject has a current moderate or severe depression as assessed by the Center for Epidemiologic Studies-Depression survey (CES-D) and physician investigator; Subject has, as defined by the Columbia Suicide Severity Rating Scale (C-SSRS) current non-specific suicidal thoughts, or have a lifetime history of a suicidal attempt (defined as "potentially self-injurious act committed with at least some wish to die, as a result of act"); Subject has current (past 30 days) major depressive disorder or has a history of another psychiatric disorder such as psychosis or bipolar disorder; Subject currently uses of other tobacco products (i.e. pipe, cigar, smokeless tobacco) within the past 30 days; Subject currently has cancer [excluding non melanoma skin cancer] not in remission (cancer free for 5 years or more); Subject currently has Type 1 diabetes; Subject has untreated hypertension or baseline systolic blood pressure > 180 or diastolic > 100; Subject is currently on treatment with another investigational drug (within 30 days of study entry);
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard D. Hurt, MD
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic in Rochester
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Franciscan Skemp Hospital
City
La Crosse
State/Province
Wisconsin
ZIP/Postal Code
54601
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29324248
Citation
Hurt RT, Ebbert JO, Croghan IT, Schroeder DR, Hurt RD, Hays JT. Varenicline for tobacco-dependence treatment in alcohol-dependent smokers: A randomized controlled trial. Drug Alcohol Depend. 2018 Mar 1;184:12-17. doi: 10.1016/j.drugalcdep.2017.11.017. Epub 2018 Jan 2.
Results Reference
result
Links:
URL
http://doi.org/10.1016/j.drugalcdep.2017.11.017
Description
Varenicline for tobacco-dependence treatment in alcohol-dependent

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Varenicline Treatment for Active Alcoholic Smokers

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