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Combination Bupropion / Varenicline for Smoking Cessation in Male Smokers (ConNic5)

Primary Purpose

Nicotine Dependence

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Chantix
Zyban
Nicotine patches
Sponsored by
Duke University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nicotine Dependence focused on measuring Nicotine addiction, Cigarette smoking, Smoking cessation, Zyban, Chantix, Nicotine patches, varenicline, bupropion

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Have no known serious medical conditions;
  • Male;
  • Are 18-65 years old;
  • Smoke an average of at least 10 cigarettes per day;
  • Have smoked at least one cumulative year;
  • Have an expired air carbon monoxide (CO) reading of at least 10ppm;
  • Able to read and understand English;
  • Express a desire to quit smoking in the next thirty days.

Potential subjects must agree to use acceptable contraception.

Potential subjects must agree to avoid the following:

  • participation in any other nicotine-related modification strategy outside of this protocol;
  • use of tobacco products other than cigarettes, including pipe tobacco, cigars, e-cigarettes, snuff, and chewing tobacco;
  • use of experimental (investigational) drugs or devices;
  • use of illegal drugs;
  • use of opiate medications.

Exclusion Criteria:

  • Hypertension;
  • Hypotension with symptoms;
  • Coronary heart disease;
  • Lifetime history of heart attack;
  • Cardiac rhythm disorder (irregular heart rhythm);
  • Chest pains (unless history, exam, and electrocardiogram (ECG) clearly indicate a non-cardiac source);
  • Cardiac (heart) disorder (including but not limited to valvular heart disease, heart murmur, heart failure);
  • History of skin allergy;
  • Active skin disorder (e.g., psoriasis) within the last five years;
  • Liver or kidney disorder (except kidney stones, gallstones);
  • Gastrointestinal problems or disease other than gastroesophageal reflux or heartburn;
  • Active ulcers in the past 30 days;
  • Currently symptomatic lung disorder/disease (including but not limited to Chronic obstructive pulmonary disease (COPD), emphysema, and asthma);
  • Brain abnormality (including but not limited to stroke, brain tumor, and seizure disorder);
  • Migraine headaches that occur more frequently than once per week;
  • Recent, unexplained fainting spells;
  • Problems giving blood samples;
  • Diabetes treated with insulin; non-insulin treated diabetes (unless glucose is less than 180mg/dcl and HbA1c is less than 7%);
  • Current cancer or treatment for cancer in the past six months (except basal or squamous cell skin cancer);
  • Other major medical condition;
  • Current psychiatric disease (with the exception of anxiety disorders, Obsessive Compulsive Disorder (OCD) and ADHD);
  • Suicidal ideation (within the past 10 years) or lifetime occurrence of attempted suicide;
  • Current depression;
  • Bulimia or anorexia;
  • Use of opiate medications for pain or sleep (non-opiate medication for pain or sleep will be allowed) within the past 14 days;
  • Smoking more than one cigar a month.
  • Alcohol abuse;
  • Significant adverse reaction to nicotine patches, bupropion / Wellbutrin / Zyban or Chantix / varenicline in the past.
  • Current participation or recent participation (in the past 30 days) in another smoking study at our Center or another research facility.
  • Current participation in another research study.

Use (within the past 30 days) of:

  • Illegal drugs (or if the urine drug screen is positive for tetrahydrocannabinol (THC), Cocaine, Amphetamine, Opiates, Methamphetamines, phencyclidine (PCP), Benzodiazepines, or Barbiturates),
  • Experimental (investigational) drugs;
  • Psychiatric medications including antidepressants, anti-psychotics or any other medications that are known to affect smoking cessation (e.g. clonidine);
  • Smokeless tobacco (chewing tobacco, snuff), pipes or e-cigarettes;
  • Wellbutrin, bupropion, Zyban, Chantix, varenicline, nicotine replacement therapy or any other smoking cessation aid.

Sites / Locations

  • Duke Center for Smoking Cessation
  • Duke Center for Smoking Cessation
  • Duke Center for Smoking Cessation
  • Duke Center for Smoking Cessation

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Chantix

Chantix + Zyban

Arm Description

For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) (occurring at one week after initiation of nicotine patch treatment, one week before the target Quit Day), smokers in this group will receive treatment with Chantix at a dose of 0.5 mg once per day followed by 0.5 mg twice a day for the remaining 4 days of that week. Subsequently, the dose will be 1 mg twice per day, and will remain at that dose for the remainder of the 12-week active treatment duration.

For the first 3 days after being switched from NRT (occurring at one week after initiation of nicotine patch treatment, one week before the target Quit Day), smokers in this group will receive treatment with Chantix at a dose of 0.5 mg once per day followed by 0.5 mg twice a day for the remaining 4 days of that week plus Zyban at a dose of 150mg once per day. Subsequently, the dose of Chantix will be 1 mg twice per day and the dose of Zyban will be 150 mg twice per day for the remainder of the 12-week active treatment duration.

Outcomes

Primary Outcome Measures

Number of Participants Completing Continuous Four-week Abstinence From Smoking Between the 8-week and 11-week Post Quit Day Visits
This will be determined by a composite of self-report at the 11-week study visit of no smoking between the 8-week and 11-week visits and expired air carbon monoxide (CO) <10 ppm (measured at the 11-week study visit). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.

Secondary Outcome Measures

Number of Participants Completing Seven-day Point Abstinence From Smoking at 6 Months Post Quit Day
This will be determined by a self-report of no smoking for the previous seven days when called for 6-month follow-up confirmed by expired air CO.
Number of Participants Completing Continuous Abstinence From Smoking Between Quit Day and 11-week Post Quit Day Visit
This will be determined by a composite of self-report of no smoking between study visits at the 1-week, 3-week, 7-week and 11-week post Quit Day study visits and expired air carbon monoxide (CO) <10 ppm (measured at those study visits). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.

Full Information

First Posted
March 6, 2013
Last Updated
December 14, 2015
Sponsor
Duke University
Collaborators
National Institute on Drug Abuse (NIDA), Philip Morris USA, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01806779
Brief Title
Combination Bupropion / Varenicline for Smoking Cessation in Male Smokers
Acronym
ConNic5
Official Title
Combination Bupropion / Varenicline for Smoking Cessation in Male Smokers
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Completed
Study Start Date
March 2013 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Duke University
Collaborators
National Institute on Drug Abuse (NIDA), Philip Morris USA, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Previous results from the investigators' Center have shown that combination treatment with Chantix and Zyban is more successful in helping men quit smoking. The investigators hope to replicate these findings with this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nicotine Dependence
Keywords
Nicotine addiction, Cigarette smoking, Smoking cessation, Zyban, Chantix, Nicotine patches, varenicline, bupropion

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
376 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Chantix
Arm Type
Experimental
Arm Description
For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) (occurring at one week after initiation of nicotine patch treatment, one week before the target Quit Day), smokers in this group will receive treatment with Chantix at a dose of 0.5 mg once per day followed by 0.5 mg twice a day for the remaining 4 days of that week. Subsequently, the dose will be 1 mg twice per day, and will remain at that dose for the remainder of the 12-week active treatment duration.
Arm Title
Chantix + Zyban
Arm Type
Experimental
Arm Description
For the first 3 days after being switched from NRT (occurring at one week after initiation of nicotine patch treatment, one week before the target Quit Day), smokers in this group will receive treatment with Chantix at a dose of 0.5 mg once per day followed by 0.5 mg twice a day for the remaining 4 days of that week plus Zyban at a dose of 150mg once per day. Subsequently, the dose of Chantix will be 1 mg twice per day and the dose of Zyban will be 150 mg twice per day for the remainder of the 12-week active treatment duration.
Intervention Type
Drug
Intervention Name(s)
Chantix
Other Intervention Name(s)
Varenicline
Intervention Type
Drug
Intervention Name(s)
Zyban
Other Intervention Name(s)
Bupropion
Intervention Type
Drug
Intervention Name(s)
Nicotine patches
Other Intervention Name(s)
NRT
Intervention Description
All participants will receive 21 mg/24 h dose nicotine (nic.) patches for 1 week.
Primary Outcome Measure Information:
Title
Number of Participants Completing Continuous Four-week Abstinence From Smoking Between the 8-week and 11-week Post Quit Day Visits
Description
This will be determined by a composite of self-report at the 11-week study visit of no smoking between the 8-week and 11-week visits and expired air carbon monoxide (CO) <10 ppm (measured at the 11-week study visit). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.
Time Frame
Period between 8-week and 11-week visits post target Quit Day
Secondary Outcome Measure Information:
Title
Number of Participants Completing Seven-day Point Abstinence From Smoking at 6 Months Post Quit Day
Description
This will be determined by a self-report of no smoking for the previous seven days when called for 6-month follow-up confirmed by expired air CO.
Time Frame
6 months post Quit Day
Title
Number of Participants Completing Continuous Abstinence From Smoking Between Quit Day and 11-week Post Quit Day Visit
Description
This will be determined by a composite of self-report of no smoking between study visits at the 1-week, 3-week, 7-week and 11-week post Quit Day study visits and expired air carbon monoxide (CO) <10 ppm (measured at those study visits). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.
Time Frame
Quit Day to 11-week post Quit Day study visit
Other Pre-specified Outcome Measures:
Title
Change in Smoking Withdrawal Symptoms
Description
Withdrawal symptoms will be assessed by questionnaire on Quit Day, Week 1, Week 3, Week 7 and Week 11 post target quit date and 6 months post quit Follow-Up (if applicable) using the Shiffman-Jarvik questionnaire, which consists of 33-items rated from 1 to 7, where 1= not at all, 2= very little, 3= a little, 4= moderately, 5= a lot, 6= quite a lot, and 7= extremely. The 33 items are grouped into 8 subscales: Craving, Negative Affect, Appetite, Arousal, Somatic - Anxiety, Somatic - G.I., Somatic - Respiratory Tract, and Habit Withdrawal. The range of scores for each subscale will be 1-7, with higher scores indicating more of the withdrawal symptom having been experienced.
Time Frame
Quit Day and 1 week, 3 weeks, 7 Weeks, 11 Weeks and 6 months post Quit Day

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have no known serious medical conditions; Male; Are 18-65 years old; Smoke an average of at least 10 cigarettes per day; Have smoked at least one cumulative year; Have an expired air carbon monoxide (CO) reading of at least 10ppm; Able to read and understand English; Express a desire to quit smoking in the next thirty days. Potential subjects must agree to use acceptable contraception. Potential subjects must agree to avoid the following: participation in any other nicotine-related modification strategy outside of this protocol; use of tobacco products other than cigarettes, including pipe tobacco, cigars, e-cigarettes, snuff, and chewing tobacco; use of experimental (investigational) drugs or devices; use of illegal drugs; use of opiate medications. Exclusion Criteria: Hypertension; Hypotension with symptoms; Coronary heart disease; Lifetime history of heart attack; Cardiac rhythm disorder (irregular heart rhythm); Chest pains (unless history, exam, and electrocardiogram (ECG) clearly indicate a non-cardiac source); Cardiac (heart) disorder (including but not limited to valvular heart disease, heart murmur, heart failure); History of skin allergy; Active skin disorder (e.g., psoriasis) within the last five years; Liver or kidney disorder (except kidney stones, gallstones); Gastrointestinal problems or disease other than gastroesophageal reflux or heartburn; Active ulcers in the past 30 days; Currently symptomatic lung disorder/disease (including but not limited to Chronic obstructive pulmonary disease (COPD), emphysema, and asthma); Brain abnormality (including but not limited to stroke, brain tumor, and seizure disorder); Migraine headaches that occur more frequently than once per week; Recent, unexplained fainting spells; Problems giving blood samples; Diabetes treated with insulin; non-insulin treated diabetes (unless glucose is less than 180mg/dcl and HbA1c is less than 7%); Current cancer or treatment for cancer in the past six months (except basal or squamous cell skin cancer); Other major medical condition; Current psychiatric disease (with the exception of anxiety disorders, Obsessive Compulsive Disorder (OCD) and ADHD); Suicidal ideation (within the past 10 years) or lifetime occurrence of attempted suicide; Current depression; Bulimia or anorexia; Use of opiate medications for pain or sleep (non-opiate medication for pain or sleep will be allowed) within the past 14 days; Smoking more than one cigar a month. Alcohol abuse; Significant adverse reaction to nicotine patches, bupropion / Wellbutrin / Zyban or Chantix / varenicline in the past. Current participation or recent participation (in the past 30 days) in another smoking study at our Center or another research facility. Current participation in another research study. Use (within the past 30 days) of: Illegal drugs (or if the urine drug screen is positive for tetrahydrocannabinol (THC), Cocaine, Amphetamine, Opiates, Methamphetamines, phencyclidine (PCP), Benzodiazepines, or Barbiturates), Experimental (investigational) drugs; Psychiatric medications including antidepressants, anti-psychotics or any other medications that are known to affect smoking cessation (e.g. clonidine); Smokeless tobacco (chewing tobacco, snuff), pipes or e-cigarettes; Wellbutrin, bupropion, Zyban, Chantix, varenicline, nicotine replacement therapy or any other smoking cessation aid.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jed E Rose, Ph.D.
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke Center for Smoking Cessation
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28210
Country
United States
Facility Name
Duke Center for Smoking Cessation
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
Duke Center for Smoking Cessation
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States
Facility Name
Duke Center for Smoking Cessation
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29054128
Citation
Rose JE, Behm FM. Combination Varenicline/Bupropion Treatment Benefits Highly Dependent Smokers in an Adaptive Smoking Cessation Paradigm. Nicotine Tob Res. 2017 Aug 1;19(8):999-1002. doi: 10.1093/ntr/ntw283.
Results Reference
derived

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Combination Bupropion / Varenicline for Smoking Cessation in Male Smokers

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