Trial Outcomes & Findings for Comparison of Varenicline and Placebo for Smoking Cessation in Schizophrenia (NCT NCT00554840)

NCT ID: NCT00554840

Last Updated: 2022-03-18

Results Overview

End expired carbon monoxide (CO) level change from baseline to determine participants' level of smoking reduction by treatment assignment. Larger negative values represent a greater level of smoking reduction.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

16 participants

Primary outcome timeframe

Weekly for 12 weeks

Results posted on

2022-03-18

Participant Flow

Stable outpatients who received their regular treatment at the Outpatient Research Program of the MPRC were invited to participate.

After the enrollment of 16 participants, a total of 7 participants were withdrawn from the study prior to assignment to a treatment group (n=9). Two subjects met exclusion criteria before any study procedures were started, and 5 subjects were withdrawn during either the "evaluation" or "pre-med" phases of the study.

Participant milestones

Participant milestones
Measure
Varenicline
varenicline: Subjects will be randomized to receive either active drug or matching placebo capsules using the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase. Subjects will be evaluated weekly for abstinence through self report, end expired CO and urine dipstick for cotinine.
Placebo
placebo: At the end of Pre-med week 1, subjects will receive study medication with the target quit date being the following week. Subjects will be randomized to receive either active drug or matching placebo capsules using the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase. Subjects will be evaluated weekly for abstinence through self report, end expired CO and urine dipstick for cotinine.
Overall Study
STARTED
4
5
Overall Study
COMPLETED
4
4
Overall Study
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Varenicline
varenicline: Subjects will be randomized to receive either active drug or matching placebo capsules using the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase. Subjects will be evaluated weekly for abstinence through self report, end expired CO and urine dipstick for cotinine.
Placebo
placebo: At the end of Pre-med week 1, subjects will receive study medication with the target quit date being the following week. Subjects will be randomized to receive either active drug or matching placebo capsules using the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase. Subjects will be evaluated weekly for abstinence through self report, end expired CO and urine dipstick for cotinine.
Overall Study
Physician Decision
0
1

Baseline Characteristics

Comparison of Varenicline and Placebo for Smoking Cessation in Schizophrenia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Varenicline
n=4 Participants
varenicline: Subjects will be randomized to receive either active drug or matching placebo capsules using the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase. Subjects will be evaluated weekly for abstinence through self report, end expired CO and urine dipstick for cotinine.
Placebo
n=4 Participants
placebo: At the end of Pre-med week 1, subjects will receive study medication with the target quit date being the following week. Subjects will be randomized to receive either active drug or matching placebo capsules using the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase. Subjects will be evaluated weekly for abstinence through self report, end expired CO and urine dipstick for cotinine.
Total
n=8 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Age, Categorical
Between 18 and 65 years
4 Participants
n=39 Participants
4 Participants
n=41 Participants
8 Participants
n=35 Participants
Age, Categorical
>=65 years
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Age, Continuous
46.3 years
STANDARD_DEVIATION 9.0 • n=39 Participants
44.3 years
STANDARD_DEVIATION 5.1 • n=41 Participants
45.97 years
STANDARD_DEVIATION 6.87 • n=35 Participants
Sex: Female, Male
Female
1 Participants
n=39 Participants
1 Participants
n=41 Participants
2 Participants
n=35 Participants
Sex: Female, Male
Male
3 Participants
n=39 Participants
3 Participants
n=41 Participants
6 Participants
n=35 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Race (NIH/OMB)
Asian
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=39 Participants
1 Participants
n=41 Participants
1 Participants
n=35 Participants
Race (NIH/OMB)
White
3 Participants
n=39 Participants
3 Participants
n=41 Participants
6 Participants
n=35 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=39 Participants
0 Participants
n=41 Participants
1 Participants
n=35 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Region of Enrollment
United States
4 participants
n=39 Participants
4 participants
n=41 Participants
8 participants
n=35 Participants

PRIMARY outcome

Timeframe: Weekly for 12 weeks

Population: Some ExpiredCO data is missing due to rater error or participant absence from that study visit.

End expired carbon monoxide (CO) level change from baseline to determine participants' level of smoking reduction by treatment assignment. Larger negative values represent a greater level of smoking reduction.

Outcome measures

Outcome measures
Measure
Varenicline
n=4 Participants
Subjects randomized to active treatment (varenicline) will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Placebo
n=4 Participants
Subjects randomized to matching placebo capsules will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Change of ExpiredCO Level From Baseline
Treatment Week 1
-2.88 ppm
Standard Deviation 8.35
9.5 ppm
Standard Deviation 6.54
Change of ExpiredCO Level From Baseline
Treatment Week 2
-17.38 ppm
Standard Deviation 22.21
-11.5 ppm
Standard Deviation 6.94
Change of ExpiredCO Level From Baseline
Treatment Week 3
-17.13 ppm
Standard Deviation 23.59
-5.75 ppm
Standard Deviation 2.40
Change of ExpiredCO Level From Baseline
Treatment Week 4
-18.63 ppm
Standard Deviation 20.77
2.5 ppm
Standard Deviation 4.10
Change of ExpiredCO Level From Baseline
Treatment Week 5
-20.63 ppm
Standard Deviation 20.27
-4.5 ppm
Standard Deviation 4.02
Change of ExpiredCO Level From Baseline
Treatment Week 6
-20.38 ppm
Standard Deviation 20.55
-3.83 ppm
Standard Deviation 7.25
Change of ExpiredCO Level From Baseline
Treatment Week 7
-20.13 ppm
Standard Deviation 20.46
-2.83 ppm
Standard Deviation 7.11
Change of ExpiredCO Level From Baseline
Treatment Week 8
-20.88 ppm
Standard Deviation 19.28
-4.83 ppm
Standard Deviation 8.40
Change of ExpiredCO Level From Baseline
Treatment Week 9
-20.88 ppm
Standard Deviation 19.98
-0.17 ppm
Standard Deviation 12.55
Change of ExpiredCO Level From Baseline
Treatment Week 10
-21.13 ppm
Standard Deviation 19.38
-2.83 ppm
Standard Deviation 9.78
Change of ExpiredCO Level From Baseline
Treatment Week 11
-19.63 ppm
Standard Deviation 20.72
8.17 ppm
Standard Deviation 17.19
Change of ExpiredCO Level From Baseline
Treatment Week 12
-19.875 ppm
Standard Deviation 18.98
-0.75 ppm
Standard Deviation 6.64

PRIMARY outcome

Timeframe: Weekly for 12 weeks

Population: Some FTND data is missing due to rater error or participant absence from that study visit.

Nicotine dependence was measured using the total score from the Fagerstrom Test for Nicotine Dependence (FTND) assessment. The total score is computed by adding the scores from the five subscales. Total scores range from 1-10, with lower scores representing a smaller degree of nicotine dependence.

Outcome measures

Outcome measures
Measure
Varenicline
n=4 Participants
Subjects randomized to active treatment (varenicline) will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Placebo
n=4 Participants
Subjects randomized to matching placebo capsules will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 0
5.88 units on a scale
Standard Deviation 1.31
5.75 units on a scale
Standard Deviation 2.10
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 1
4.5 units on a scale
Standard Deviation 1.30
5.25 units on a scale
Standard Deviation 2.06
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 2
4.33 units on a scale
Standard Deviation 0.58
4.75 units on a scale
Standard Deviation 2.06
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 3
3 units on a scale
Standard Deviation 3
4.5 units on a scale
Standard Deviation 1.91
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 4
3 units on a scale
Standard Deviation 3
5 units on a scale
Standard Deviation 1.83
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 5
2.75 units on a scale
Standard Deviation 2.22
5.25 units on a scale
Standard Deviation 1.71
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 6
4.25 units on a scale
Standard Deviation 1.71
4.33 units on a scale
Standard Deviation 1.53
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 7
4.5 units on a scale
Standard Deviation 1.73
4.67 units on a scale
Standard Deviation 1.53
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 8
4.75 units on a scale
Standard Deviation 1.89
4 units on a scale
Standard Deviation 1.73
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 9
5 units on a scale
Standard Deviation 2.16
3.67 units on a scale
Standard Deviation 2.08
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 10
5 units on a scale
Standard Deviation 2
3.67 units on a scale
Standard Deviation 2.08
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 11
6 units on a scale
Standard Deviation 1
4.33 units on a scale
Standard Deviation 1.53
Level of Nicotine Dependence by Treatment Assignment
Treatment Week 12
3.5 units on a scale
Standard Deviation 3.11
4.25 units on a scale
Standard Deviation 1.5

SECONDARY outcome

Timeframe: Baseline (week 0) then again during the Treatment Phase at weeks 1, 2, 4, 8, and 12.

Population: Some BPRS total score data is missing due to rater error or participant absence from that study visit.

The total BPRS score is calculated by adding the scores for subscales #1-#18. Each scale ranges from "1=Not Present" to "7=Very Severe". Total scores range from a minimum score of 18 to a maximum score of 126. A higher total score indicates a more severe psychiatric symptom rating.

Outcome measures

Outcome measures
Measure
Varenicline
n=4 Participants
Subjects randomized to active treatment (varenicline) will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Placebo
n=4 Participants
Subjects randomized to matching placebo capsules will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Brief Psychiatric Rating Scale (BPRS) - Total Score
Baseline
35.75 units on a scale
Standard Deviation 6.34
30.25 units on a scale
Standard Deviation 4.11
Brief Psychiatric Rating Scale (BPRS) - Total Score
Treatment Week 1
33.75 units on a scale
Standard Deviation 5.56
32.75 units on a scale
Standard Deviation 6.6
Brief Psychiatric Rating Scale (BPRS) - Total Score
Treatment Week 2
35.5 units on a scale
Standard Deviation 7
30.25 units on a scale
Standard Deviation 4.35
Brief Psychiatric Rating Scale (BPRS) - Total Score
Treatment Week 4
31.75 units on a scale
Standard Deviation 3.4
30.25 units on a scale
Standard Deviation 6.75
Brief Psychiatric Rating Scale (BPRS) - Total Score
Treatment Week 8
36.25 units on a scale
Standard Deviation 4.27
28 units on a scale
Standard Deviation 2.65
Brief Psychiatric Rating Scale (BPRS) - Total Score
Treatment Week 12
34.75 units on a scale
Standard Deviation 3.30
32 units on a scale
Standard Deviation 3.92

SECONDARY outcome

Timeframe: Baseline (week 0) then again during the Treatment Phase at weeks 1, 2, 4, 8, and 12.

Population: Some BPRS total score data is missing due to rater error or participant absence from that study visit.

The psychosis score is calculated by adding the scores for scales #4 Conceptual Disorganization, #11 Suspiciousness, #12 Hallucinatory Behavior, and #15 Unusual Thought Content. Each scale ranges from "1=Not Present" to "7=Very Severe". The minimum psychosis score is 4 and the maximum psychosis score is 28. A higher score indicates a more severe psychosis rating.

Outcome measures

Outcome measures
Measure
Varenicline
n=4 Participants
Subjects randomized to active treatment (varenicline) will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Placebo
n=4 Participants
Subjects randomized to matching placebo capsules will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Brief Psychiatric Rating Scale (BPRS) - Psychosis Score
Baseline
11.25 units on a scale
Standard Deviation 2.22
10 units on a scale
Standard Deviation 5.94
Brief Psychiatric Rating Scale (BPRS) - Psychosis Score
Treatment Week 1
8.5 units on a scale
Standard Deviation 3.12
11.5 units on a scale
Standard Deviation 6.03
Brief Psychiatric Rating Scale (BPRS) - Psychosis Score
Treatment Week 2
9.25 units on a scale
Standard Deviation 4.03
8.5 units on a scale
Standard Deviation 4.51
Brief Psychiatric Rating Scale (BPRS) - Psychosis Score
Treatment Week 4
8.25 units on a scale
Standard Deviation 4.03
8.5 units on a scale
Standard Deviation 4.65
Brief Psychiatric Rating Scale (BPRS) - Psychosis Score
Treatment Week 8
10.75 units on a scale
Standard Deviation 3.3
7.67 units on a scale
Standard Deviation 1.53
Brief Psychiatric Rating Scale (BPRS) - Psychosis Score
Treatment Week 12
8.75 units on a scale
Standard Deviation 2.22
10.5 units on a scale
Standard Deviation 3.87

SECONDARY outcome

Timeframe: Baseline (week 0) then again during the Treatment Phase at weeks 1, 2, 4, 8, and 12.

Population: Some BPRS anxiety/depression score data is missing due to rater error or participant absence from that study visit.

The anxiety/depression score is calculated by adding the scores for scales #2 Anxiety and #9 Depressive Mood. Each scale ranges from "1=Not Present" to "7=Very Severe". The minimum anxiety/depression score is 2 and the maximum psychosis score is 14. A higher score indicates a more severe anxiety/depression rating.

Outcome measures

Outcome measures
Measure
Varenicline
n=4 Participants
Subjects randomized to active treatment (varenicline) will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Placebo
n=4 Participants
Subjects randomized to matching placebo capsules will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Brief Psychiatric Rating Scale (BPRS) - Anxiety/Depression Score
Baseline
5.5 units on a scale
Standard Deviation 1.3
6.75 units on a scale
Standard Deviation 2.06
Brief Psychiatric Rating Scale (BPRS) - Anxiety/Depression Score
Treatment Week 1
3.25 units on a scale
Standard Deviation 0.96
8 units on a scale
Standard Deviation 3.27
Brief Psychiatric Rating Scale (BPRS) - Anxiety/Depression Score
Treatment Week 2
7.25 units on a scale
Standard Deviation 1.71
7.25 units on a scale
Standard Deviation 2.99
Brief Psychiatric Rating Scale (BPRS) - Anxiety/Depression Score
Treatment Week 4
6.25 units on a scale
Standard Deviation 1.71
8 units on a scale
Standard Deviation 4.32
Brief Psychiatric Rating Scale (BPRS) - Anxiety/Depression Score
Treatment Week 8
7.25 units on a scale
Standard Deviation 0.5
3.37 units on a scale
Standard Deviation 2.52
Brief Psychiatric Rating Scale (BPRS) - Anxiety/Depression Score
Treatment Week 12
7 units on a scale
Standard Deviation 1.41
7.5 units on a scale
Standard Deviation 2.65

SECONDARY outcome

Timeframe: Weekly for 12 weeks

Side effects (33 items) were measured using a Side Effects Checklist (SEC). The percentage of participants endorsing each side effect were reported regardless of the severity or relation to study drug.

Outcome measures

Outcome measures
Measure
Varenicline
n=4 Participants
Subjects randomized to active treatment (varenicline) will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Placebo
n=4 Participants
Subjects randomized to matching placebo capsules will use the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Side Effects
Abdominal pain
1 Participants
4 Participants
Side Effects
Anorexia
0 Participants
1 Participants
Side Effects
Bruising
0 Participants
0 Participants
Side Effects
Constipation
2 Participants
0 Participants
Side Effects
Diarrhea
1 Participants
0 Participants
Side Effects
Dizziness
1 Participants
2 Participants
Side Effects
Dry mouth
0 Participants
2 Participants
Side Effects
Enuresis
0 Participants
2 Participants
Side Effects
Fever
0 Participants
0 Participants
Side Effects
Headache
1 Participants
1 Participants
Side Effects
Insomnia
3 Participants
1 Participants
Side Effects
Malaise
2 Participants
1 Participants
Side Effects
Mucosal ulceration
0 Participants
0 Participants
Side Effects
Nausea
3 Participants
1 Participants
Side Effects
Rash
1 Participants
1 Participants
Side Effects
Restlessness
0 Participants
1 Participants
Side Effects
Hypersalivation
3 Participants
1 Participants
Side Effects
Sedation
2 Participants
2 Participants
Side Effects
Stiffness
0 Participants
1 Participants
Side Effects
Sore throat
1 Participants
1 Participants
Side Effects
Tremor
0 Participants
1 Participants
Side Effects
Uticaria
1 Participants
1 Participants
Side Effects
Vomiting
0 Participants
1 Participants
Side Effects
Weight loss
1 Participants
0 Participants
Side Effects
Tinnitus
0 Participants
0 Participants

Adverse Events

Varenicline

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Placebo

Serious events: 1 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Varenicline
n=4 participants at risk
Subjects randomized to receive active drug (varenicline) will have the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Placebo
n=4 participants at risk
Subjects randomized to matching placebo will have the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Psychiatric disorders
Hospitalization
0.00%
0/4 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
25.0%
1/4 • Number of events 1 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).

Other adverse events

Other adverse events
Measure
Varenicline
n=4 participants at risk
Subjects randomized to receive active drug (varenicline) will have the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Placebo
n=4 participants at risk
Subjects randomized to matching placebo will have the following titration schedule: 0.5mg for three days, 0.5mg twice daily for the next four days, then 1mg twice daily for the rest of the treatment phase.
Ear and labyrinth disorders
Dizziness
25.0%
1/4 • Number of events 1 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
0.00%
0/4 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
General disorders
Headache
25.0%
1/4 • Number of events 1 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
0.00%
0/4 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
General disorders
Dry mouth
0.00%
0/4 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
25.0%
1/4 • Number of events 1 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
Skin and subcutaneous tissue disorders
Rash
25.0%
1/4 • Number of events 1 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
25.0%
1/4 • Number of events 1 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
Hepatobiliary disorders
Elevated liver enzymes
25.0%
1/4 • Number of events 1 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
0.00%
0/4 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
General disorders
Malaise
25.0%
1/4 • Number of events 3 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
0.00%
0/4 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
General disorders
Abdominal pain
25.0%
1/4 • Number of events 1 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).
0.00%
0/4 • Adverse event data was collected for each participant for their entire duration of the study (up to 20 weeks).

Additional Information

Elaine Weiner, M.D.

Maryland Psychiatric Research Center

Phone: 410-402-7694

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place