Author Affiliations: Department of Internal Medicine, Baystate Medical Center/Tufts University School of Medicine, Springfield, Massachusetts.
In their recent study of varenicline tartrate, Hajek et al1 found that beginning therapy 4 weeks before the target quit date improved 12-week abstinence rates compared with the usual practice of beginningtherapy 1 week before quitting. It is interesting to note that the 47.2% abstinence rate in the intervention group is almost identical to the rates observed in previous randomized trials of varenicline (42%-47%) in which therapy was started only 1 week before quitting.2-5 More perplexing is the strikingly low quit rate of 20.8% in the placebo group, which received a regimen similar to that of active participants in the previous studies. At the same time, the rate of reported nausea—59% in the active group and 48% in the placebo group—was twice that previously reported.
Dhelaria RK, Rothberg M. Is Varenicline Effectiveness Declining in Randomized Trials? Arch Intern Med. 2011;171(19):1770–1772. doi:10.1001/archinternmed.2011.493
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