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Mechanistic Evaluations of Pre-Cessation Therapies for Smoking Cessation (ConNicBrain)

Primary Purpose

Nicotine Dependence

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Varenicline
Bupropion
Nicotine patches
Placebo varenicline
Placebo bupropion
Placebo patch
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, fMRI

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Are generally healthy;
  • Are 18-50 years old;
  • Smoke an average of at least 10 cigarettes per day for at least three cumulative years;
  • Have an afternoon expired air carbon monoxide (CO) reading of at least 10ppm;
  • Are right-handed as measured by a two-item scale used in our laboratory;
  • Express a desire to quit smoking in the next thirty days.
  • Potential subjects must agree to use acceptable contraception during their participation in this study.

Potential subjects must agree to avoid the following during their participation in this study:

  • 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:

  • Inability to attend all required experimental sessions;
  • Presence of conditions that would make MRI unsafe (e.g. pacemaker);
  • Hypertension (systolic >140 mm Hg, diastolic >100 mm Hg, coupled with a history of hypertension); subjects with no previous diagnosis of hypertension may have a screening blood pressure up to 160/100.
  • Hypotension with symptoms (systolic <90 mm Hg, diastolic <60 mm Hg).
  • Coronary heart disease;
  • Lifetime history of heart attack;
  • Cardiac rhythm disorder (irregular heart rhythm);
  • Chest pains (unless history, exam, and 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, except minor skin conditions (including but not limited to facial acne, minor localized infections, and superficial minor wounds);
  • 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;
  • Lung disorder (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;
  • 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 Attention deficit hyperactivity disorder (ADHD));
  • Bulimia or anorexia;
  • Suicidal ideation (within the past 10 years) or lifetime occurrence of attempted suicide;
  • Current depression;
  • Pregnant or nursing mothers;
  • Alcohol abuse;
  • Significant adverse reaction to nicotine patch, bupropion/Wellbutrin/Zyban or Chantix/Varenicline in the past.
  • Use (within the past 30 days) of:

    • Illegal drugs (or if the urine drug screen is positive);
    • 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), cigars or pipes;
    • Nicotine replacement therapy or any other smoking cessation aid.
  • Use (within the past 14 days) of:

    • Opiate medications for pain or sleep (non-opiate medication for pain or sleep will be allowed).

Sites / Locations

  • Duke Center for Nicotine and Smoking Cessation Research
  • Duke Center for Nicotine and Smoking Cessation Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

varenicline

NRT (nicotine patches only)

varenicline + bupropion

Post-quit NRT

Arm Description

For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) occurring at one week before the target quit date, smokers in this group will receive varenicline 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 weeks. During the time they receive varenicline, smokers in this group will also receive placebo bupropion and placebo patches.

21 mg/24 h for 2 weeks before the quit date and 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. After the 1st week, smokers in this group will also receive placebo bupropion and placebo varenicline.

For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) occurring at one week before the target quit date, smokers in this group will receive varenicline 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 bupropion at a dose of 150mg once per day. Subsequently, the dose of varenicline will be 1 mg twice per day and the dose of bupropion will be 150 mg twice per day, and will remain at that dose for the remainder of the 12 weeks. During the time they receive varenicline and bupropion, smokers in this group will also receive placebo patches.

Nicotine patches at 21 mg/24 h for 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. After the 1st week, smokers in this group will also receive placebo bupropion and placebo varenicline.

Outcomes

Primary Outcome Measures

The Amygdala, Anterior Insula, and Medial Prefrontal Cortex Scans Will be Compared to Evaluate Significant Differences
Mean blood-oxygen-level dependent (BOLD) contrast sensitive functional magnetic resonance imaging (fMRI) cue-reactivity signal following 2 week pre-quit treatment, controlling for baseline cue-reactivity.

Secondary Outcome Measures

Days to First Cigarette Following Quitting Smoking
Days to first cigarette (i.e. lapse) will be measured via self-report.

Full Information

First Posted
June 12, 2011
Last Updated
October 12, 2017
Sponsor
Duke University
Collaborators
National Institute on Drug Abuse (NIDA)
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1. Study Identification

Unique Protocol Identification Number
NCT01406223
Brief Title
Mechanistic Evaluations of Pre-Cessation Therapies for Smoking Cessation
Acronym
ConNicBrain
Official Title
Mechanistic Evaluations of Pre-Cessation Therapies for Smoking Cessation
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
July 2011 (undefined)
Primary Completion Date
December 2013 (Actual)
Study Completion Date
June 2014 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to look at brain function in order to understand how different treatments work to help people quit smoking. In this study, the investigators will look at the effects of nicotine patches, Chantix alone or Chantix paired with Zyban.

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, fMRI

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
282 (Actual)

8. Arms, Groups, and Interventions

Arm Title
varenicline
Arm Type
Active Comparator
Arm Description
For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) occurring at one week before the target quit date, smokers in this group will receive varenicline 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 weeks. During the time they receive varenicline, smokers in this group will also receive placebo bupropion and placebo patches.
Arm Title
NRT (nicotine patches only)
Arm Type
Active Comparator
Arm Description
21 mg/24 h for 2 weeks before the quit date and 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. After the 1st week, smokers in this group will also receive placebo bupropion and placebo varenicline.
Arm Title
varenicline + bupropion
Arm Type
Active Comparator
Arm Description
For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) occurring at one week before the target quit date, smokers in this group will receive varenicline 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 bupropion at a dose of 150mg once per day. Subsequently, the dose of varenicline will be 1 mg twice per day and the dose of bupropion will be 150 mg twice per day, and will remain at that dose for the remainder of the 12 weeks. During the time they receive varenicline and bupropion, smokers in this group will also receive placebo patches.
Arm Title
Post-quit NRT
Arm Type
Placebo Comparator
Arm Description
Nicotine patches at 21 mg/24 h for 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. After the 1st week, smokers in this group will also receive placebo bupropion and placebo varenicline.
Intervention Type
Drug
Intervention Name(s)
Varenicline
Other Intervention Name(s)
Chantix
Intervention Type
Drug
Intervention Name(s)
Bupropion
Other Intervention Name(s)
Zyban
Intervention Type
Drug
Intervention Name(s)
Nicotine patches
Other Intervention Name(s)
Nicoderm
Intervention Type
Other
Intervention Name(s)
Placebo varenicline
Intervention Type
Other
Intervention Name(s)
Placebo bupropion
Intervention Type
Other
Intervention Name(s)
Placebo patch
Primary Outcome Measure Information:
Title
The Amygdala, Anterior Insula, and Medial Prefrontal Cortex Scans Will be Compared to Evaluate Significant Differences
Description
Mean blood-oxygen-level dependent (BOLD) contrast sensitive functional magnetic resonance imaging (fMRI) cue-reactivity signal following 2 week pre-quit treatment, controlling for baseline cue-reactivity.
Time Frame
change from baseline in whole brain blood-oxygen-level dependent (BOLD) contrast sensitive functional magnetic resonance imaging (fMRI) images collected during a cue-reactivity task following 2 weeks of pre-quit treatment
Secondary Outcome Measure Information:
Title
Days to First Cigarette Following Quitting Smoking
Description
Days to first cigarette (i.e. lapse) will be measured via self-report.
Time Frame
Up to 11 weeks post quit day.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Are generally healthy; Are 18-50 years old; Smoke an average of at least 10 cigarettes per day for at least three cumulative years; Have an afternoon expired air carbon monoxide (CO) reading of at least 10ppm; Are right-handed as measured by a two-item scale used in our laboratory; Express a desire to quit smoking in the next thirty days. Potential subjects must agree to use acceptable contraception during their participation in this study. Potential subjects must agree to avoid the following during their participation in this study: 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: Inability to attend all required experimental sessions; Presence of conditions that would make MRI unsafe (e.g. pacemaker); Hypertension (systolic >140 mm Hg, diastolic >100 mm Hg, coupled with a history of hypertension); subjects with no previous diagnosis of hypertension may have a screening blood pressure up to 160/100. Hypotension with symptoms (systolic <90 mm Hg, diastolic <60 mm Hg). Coronary heart disease; Lifetime history of heart attack; Cardiac rhythm disorder (irregular heart rhythm); Chest pains (unless history, exam, and 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, except minor skin conditions (including but not limited to facial acne, minor localized infections, and superficial minor wounds); 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; Lung disorder (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; 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 Attention deficit hyperactivity disorder (ADHD)); Bulimia or anorexia; Suicidal ideation (within the past 10 years) or lifetime occurrence of attempted suicide; Current depression; Pregnant or nursing mothers; Alcohol abuse; Significant adverse reaction to nicotine patch, bupropion/Wellbutrin/Zyban or Chantix/Varenicline in the past. Use (within the past 30 days) of: Illegal drugs (or if the urine drug screen is positive); 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), cigars or pipes; Nicotine replacement therapy or any other smoking cessation aid. Use (within the past 14 days) of: Opiate medications for pain or sleep (non-opiate medication for pain or sleep will be allowed).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
F. Joseph McClernon, Ph.D.
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke Center for Nicotine and Smoking Cessation Research
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
Duke Center for Nicotine and Smoking Cessation Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States

12. IPD Sharing Statement

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Mechanistic Evaluations of Pre-Cessation Therapies for Smoking Cessation

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