Titre
Varenicline: mode of action, efficacy, safety and accumulated experience salient for clinical populations.
Type
synthèse (review)
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Tonstad, S.
Auteure/Auteur
Arons, C.
Auteure/Auteur
Rollema, H.
Auteure/Auteur
Berlin, I.
Auteure/Auteur
Hajek, P.
Auteure/Auteur
Fagerström, K.
Auteure/Auteur
Els, C.
Auteure/Auteur
McRae, T.
Auteure/Auteur
Russ, C.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1473-4877
Statut éditorial
Publié
Date de publication
2020-05
Volume
36
Numéro
5
Première page
713
Dernière page/numéro d’article
730
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Résumé
Objective: Varenicline, a selective partial agonist of the α4β2 nicotinic acetylcholine receptor, is a smoking cessation pharmacotherapy that more than doubles the chance of quitting smoking at 6 months compared with placebo. This article reviews salient knowledge of the discovery, pharmacological characteristics, and the efficacy and safety of varenicline in general and in specific populations of smokers and provides recommendations to support use in clinical practice.Methods: Literature searches for varenicline were conducted using PubMed, with date limitations of 2000-2018 inclusive, using search terms covering the discovery, mechanism of action, pharmacokinetics, efficacy and safety in different populations of smokers, alternative quit approaches and combination therapy. Selection of safety and efficacy data was limited to clinical trials, meta-analyses and observational studies.Results: Standard administration of varenicline is efficacious in helping smokers to quit, including smokers with cardiovascular disease and chronic obstructive pulmonary disease. Furthermore, varenicline efficacy may be improved with pre-loading, a gradual quitting approach for smokers unwilling or unable to quit abruptly, and extended treatment in smokers who have recently quit to help maintain abstinence. Initial concerns regarding the association of varenicline with increased risk of neuropsychiatric and cardiovascular adverse events have been disproven after extensive clinical evaluations, and the benefit-risk profile of varenicline is considered favorable.Conclusions: Varenicline is efficacious and safe for all adult smokers with a range of clinical characteristics. Evidence suggests that approaches offering greater flexibility in timing and duration of treatment may further extend treatment efficacy and clinical reach.
PID Serval
serval:BIB_33546B6CA64B
PMID
Open Access
Oui
Date de création
2020-02-17T15:59:34.773Z
Date de création dans IRIS
2025-05-20T16:26:17Z