The study, “Smoking cessation medicines and e-cigarettes: a systematic review, network meta-analysis and cost-effectiveness analysis,” was conducted by researchers from the University of Bristol in the United Kingdom. They searched publication databases through March 2017 and updated February 2019 for randomized clinical trials of smoking cessation lasting ≥6 months.
The research team finally included a total of 363 trials with 201,045 participants, while an additional 53 observational studies comprising 8,783,5403 participants were included for a safety review.
After analysing the findings, the research team concluded that the most effective treatments were Varenicline standard plus nicotine replacement (odds ratio [OR], 3.22; 95% credible interval [CrI], 2.27-14.88), varenicline low plus nicotine replacement (OR, 5.70; 95% CrI, 1.57-21.12), and e-cigarette low (OR, 3.22; 95% CrI, 0.97-12.55).
A controversial drug
On October 1st 2021, Varenciline, which is generally sold under the name Chantix, was added to the WHO’s Essential Medicines List. The anti-smoking drug renowned for getting smokers over any cigarette cravings. However considered significantly effective, it is also known to cause moderate to severe psychological side effects, from horrifying nightmares to suicidal thoughts.
After numerous reports about such disturbances, the US Food and Drug Administration (FDA) had placed the most severe warning available on the medication, which led to Chantix’s sales dropping from $846 million in 2008, to $671 million last year.
To compensate for this drop, its manufacturer, Pfizer, had invested heavily in advertising and settling lawsuits against the drug. Moreover, the Pharma company had released data retrieved from a study which allegedly proved that there is no direct link between the consumption of Chantix and experiencing psychological disturbances.
Subsequently, after refusing to lift the warning in 2014, the FDA had recently decided to change its stance and drop the warning. The agency required that the medication have its side effects listed, it also specified that the label should state that Chantix is more effective than other smoking cessation therapies.
Varenicline stock recalled
Meanwhile last June, Pfizer was forced to halt the distribution of Chantix and recall some stock after finding elevated levels of nitrosamines in the pills. However, the following month the FDA said it will temporarily allow some manufacturers to distribute the carcinogen-containing drug, below an interim limit of 185 ng per day, until the impurity can be eliminated or reduced to acceptable levels.
Read Further: Psychiatry Advisor
