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Combining Varenicline and Naltrexone for Smoking Cessation

Primary Purpose

Nicotine Dependence, Alcohol Use Disorder

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Varenicline
Varenicline plus Naltrexone
Sponsored by
University of California, Los Angeles
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nicotine Dependence

Eligibility Criteria

21 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Be treatment-seeking for smoking cessation and have a desire to reduce or quit drinking
  2. Be between the ages of 21 and 65
  3. Be able to provide informed consent
  4. Smoke 5 or more cigarettes per day for the past year
  5. Currently drink heavily according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines: for men, > 14 drinks per week or ≥ 5 drinks per occasion at least once per month over the past 12 months; for women, > 7 drinks per week or ≥ 4 drinks per occasion at least once per month over the past 12 months
  6. Pass the physical exam and associated laboratory tests, as determined by study physician

Exclusion Criteria:

  1. Have clinically significant alcohol withdrawal, indicated by a score ≥ 10 on the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) and assessed at the in-person screening visits
  2. Have lifetime DSM-V diagnosis of schizophrenia, bipolar disorder, a psychotic disorder, or any other psychiatric disorder as determined by the clinical interview
  3. Have major depressive disorder within the past year requiring treatment as determined by the clinical interview using DSM-V criteria
  4. Have a current or lifetime DSM-V diagnosis of a substance use disorder, other than for alcohol or nicotine, as determined by the clinical interview
  5. Have a prior history of taking FDA approved medications (i.e. varenicline or bupropion) for smoking cessation
  6. Be currently using any forms of nicotine replacement therapy (past use is acceptable)
  7. Be currently using tobacco products other than cigarettes (such as e-cigarettes, cigars, or chewing tobacco)
  8. Have a serious medical illness (significant cardiovascular disease; uncontrolled hypertension; hepatic or renal disease) that would contraindicate participation, as determined by the study physician
  9. Be currently taking insulin or oral hypoglycemic medication
  10. Be currently taking opioid pain medications or any form of opioid agonist maintenance therapy (such as methadone or buprenorphine)
  11. Be currently taking any other psychoactive medications; such as anti-depressants, mood stabilizers, anti-seizure medications, sedatives-hypnotics, anxiolytics, stimulants or antipsychotics
  12. Have self-reported use of cocaine, methamphetamine, heroin or other illicit drugs in the previous 60 days, verified by urine toxicology screen
  13. For women, must not be pregnant (as indicated by self-report or a positive pregnancy test at any study visit), nursing, or planning to become pregnant while taking part in the study, and must agree to a reliable method of birth control

Sites / Locations

  • UCLA Addictions Laboratory

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Varenicline plus Naltrexone

Varenicline

Arm Description

VAR (1 mg twice daily) + NTX (50 mg once daily)

VAR (1 mg twice daily)

Outcomes

Primary Outcome Measures

Number of Participants With Expired Carbon Monoxide Level <=5ppm
Outcome for smoking cessation aim was Expired Carbon Monoxide level, which was used to determine whether a participant successfully abstained from cigarettes. 7 day point prevalence of nicotine abstinence was bioverified by Expired Carbon Monoxide reading of <= 5ppm at the 26-week follow-up visit.

Secondary Outcome Measures

Drinks Per Drinking Day
Outcome for drinking reduction aim - Number of Drinks per Drinking Day

Full Information

First Posted
February 19, 2016
Last Updated
May 20, 2021
Sponsor
University of California, Los Angeles
Collaborators
National Institute on Drug Abuse (NIDA)
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1. Study Identification

Unique Protocol Identification Number
NCT02698215
Brief Title
Combining Varenicline and Naltrexone for Smoking Cessation
Official Title
Combining Varenicline and Naltrexone for Smoking Cessation and Drinking Reduction
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
May 2016 (Actual)
Primary Completion Date
December 2019 (Actual)
Study Completion Date
December 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of California, Los Angeles
Collaborators
National Institute on Drug Abuse (NIDA)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is a double-blind, randomized clinical trial using a two group medication design consisting of the combination of VAR (1 mg twice daily) + NTX (50 mg once daily) and VAR (1 mg twice daily) + PLA (matched to NTX), for smoking cessation in a sample of heavy drinking daily smokers who want to quit smoking and reduce drinking.
Detailed Description
This study is a double-blind, randomized clinical trial using a two group medication design consisting of the combination of VAR (1 mg twice daily) + NTX (50 mg once daily) and VAR (1 mg twice daily) + PLA (matched to NTX), for smoking cessation in a sample of heavy drinking daily smokers who want to quit smoking and reduce drinking. All participants will be daily smokers (≥ 5 cig/day) who are also heavy drinkers according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines: for men, > 14 drinks per week or ≥ 5 drinks per occasion at least once per month over the past 12 months; for women, > 7 drinks per week or ≥ 4 drinks per occasion at least once per month over the past 12 months. A total of 274 participants will be randomized, 137 to each medication group.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nicotine Dependence, Alcohol Use Disorder

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
165 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Varenicline plus Naltrexone
Arm Type
Experimental
Arm Description
VAR (1 mg twice daily) + NTX (50 mg once daily)
Arm Title
Varenicline
Arm Type
Placebo Comparator
Arm Description
VAR (1 mg twice daily)
Intervention Type
Drug
Intervention Name(s)
Varenicline
Other Intervention Name(s)
Chantix
Intervention Description
Varenicline 1 mg twice daily
Intervention Type
Drug
Intervention Name(s)
Varenicline plus Naltrexone
Other Intervention Name(s)
Chantix, Revia
Intervention Description
Varenicline 1 mg twice daily plus Naltrexone 50 mg once daily
Primary Outcome Measure Information:
Title
Number of Participants With Expired Carbon Monoxide Level <=5ppm
Description
Outcome for smoking cessation aim was Expired Carbon Monoxide level, which was used to determine whether a participant successfully abstained from cigarettes. 7 day point prevalence of nicotine abstinence was bioverified by Expired Carbon Monoxide reading of <= 5ppm at the 26-week follow-up visit.
Time Frame
26 weeks post-quit
Secondary Outcome Measure Information:
Title
Drinks Per Drinking Day
Description
Outcome for drinking reduction aim - Number of Drinks per Drinking Day
Time Frame
26 weeks post-quit

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be treatment-seeking for smoking cessation and have a desire to reduce or quit drinking Be between the ages of 21 and 65 Be able to provide informed consent Smoke 5 or more cigarettes per day for the past year Currently drink heavily according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines: for men, > 14 drinks per week or ≥ 5 drinks per occasion at least once per month over the past 12 months; for women, > 7 drinks per week or ≥ 4 drinks per occasion at least once per month over the past 12 months Pass the physical exam and associated laboratory tests, as determined by study physician Exclusion Criteria: Have clinically significant alcohol withdrawal, indicated by a score ≥ 10 on the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) and assessed at the in-person screening visits Have lifetime DSM-V diagnosis of schizophrenia, bipolar disorder, a psychotic disorder, or any other psychiatric disorder as determined by the clinical interview Have major depressive disorder within the past year requiring treatment as determined by the clinical interview using DSM-V criteria Have a current or lifetime DSM-V diagnosis of a substance use disorder, other than for alcohol or nicotine, as determined by the clinical interview Have a prior history of taking FDA approved medications (i.e. varenicline or bupropion) for smoking cessation Be currently using any forms of nicotine replacement therapy (past use is acceptable) Be currently using tobacco products other than cigarettes (such as e-cigarettes, cigars, or chewing tobacco) Have a serious medical illness (significant cardiovascular disease; uncontrolled hypertension; hepatic or renal disease) that would contraindicate participation, as determined by the study physician Be currently taking insulin or oral hypoglycemic medication Be currently taking opioid pain medications or any form of opioid agonist maintenance therapy (such as methadone or buprenorphine) Be currently taking any other psychoactive medications; such as anti-depressants, mood stabilizers, anti-seizure medications, sedatives-hypnotics, anxiolytics, stimulants or antipsychotics Have self-reported use of cocaine, methamphetamine, heroin or other illicit drugs in the previous 60 days, verified by urine toxicology screen For women, must not be pregnant (as indicated by self-report or a positive pregnancy test at any study visit), nursing, or planning to become pregnant while taking part in the study, and must agree to a reliable method of birth control
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lara Ray, PhD
Organizational Affiliation
University of California, Los Angeles
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCLA Addictions Laboratory
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34968106
Citation
Green R, Montoya AK, Ray LA. The relationship between drinking and smoking in a clinical trial for smoking cessation and drinking reduction. Exp Clin Psychopharmacol. 2022 Dec;30(6):873-883. doi: 10.1037/pha0000536. Epub 2021 Dec 30.
Results Reference
derived
PubMed Identifier
34080890
Citation
Ray LA, Green R, Enders C, Leventhal AM, Grodin EN, Li G, Lim A, Hartwell E, Venegas A, Meredith L, Nieto SJ, Shoptaw S, Ho D, Miotto K. Efficacy of Combining Varenicline and Naltrexone for Smoking Cessation and Drinking Reduction: A Randomized Clinical Trial. Am J Psychiatry. 2021 Sep 1;178(9):818-828. doi: 10.1176/appi.ajp.2020.20070993. Epub 2021 Jun 3.
Results Reference
derived

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Combining Varenicline and Naltrexone for Smoking Cessation

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