Chantix helps people with emphysema stop smoking

Varenicline - marketed by Pfizer as Chantix—is a safe, well-tolerated and effective way for people with emphysema - also known as chronic obstructive pulmonary disease, or COPD - to stop smoking, according to study findings presented this week at the CHEST 2009 meeting in San Diego, California.

“Smoking is the most important risk factor for the development and progression of COPD, and yet smokers with COPD have greater difficulty in quitting smoking than smokers in general,” lead researcher Dr. Donald Tashkin told Reuters Health. “Therefore, it is important to determine the most effective means of helping smokers with this disease to quit and thereby slow or halt the progression of their disease.”

Studies of the best way for people with COPD to quit have been limited, and none have tested varenicline, which Tashkin, at the University of California at Los Angeles, said appears to be the most effective smoking cessation drug.

Tashkin and his colleagues studied nearly 500 smokers with mild to moderate COPD who either received varenicline or an inactive pill for 12 weeks. The subjects were then followed for 40 additional weeks without treatment.

On average, the group was 57 years old, had begun smoking at 16, and had smoked 24 cigarettes per day in the last month.

Using breath analysis, the researchers found that more than 40 percent of those who received varenicline had stopped smoking by weeks 9 through 12, compared to less than 10 percent of those who received the inactive pill.

Between weeks 9 and 52, many of those who quit went back to smoking, but about 19 percent of the varenicline were still not smoking, compared to about 6 percent of those who did not receive the drug.

The side effects most often seen with varenicline were nausea, abnormal dreams, and insomnia. Serious side effects were slightly less common in the varenicline group. One person in the varenicline group had suicidal thoughts, and two in that group died. One in the non-varenicline group died.

In July, the U.S. Food and Drug Administration in July required that Chantix and GlaxoSmithKline’s Zyban (bupropion) carry warnings about risks of depression, suicidal thoughts, hostility and behavior changes.

“Future research,” Dr. Tashkin concluded, “needs to be aimed at developing even more effective strategies for achieving both smoking cessation and sustained abstinence, given that even with the best therapy available today, the relapse rate is still relatively high so that a year after initiation of treatment, approximately 80 percent of smokers are still smoking.”

By Anthony J. Brown, MD

NEW YORK (Reuters Health)