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Dtsch Med Wochenschr 2012; 137(18): 940-944
DOI: 10.1055/s-0032-1304895
Arzneimittel & Pharmakotherapie | Review article
Pharmakotherapie, Suchtmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Effektivität und Sicherheit von Vareniclin zur Raucherentwöhnung

Effectiveness and safety of varenicline for smoking cessation
P. Christalla
1   Abteilung Pharmakologie, Universitätsmedizin Göttingen
,
M. Dewenter
1   Abteilung Pharmakologie, Universitätsmedizin Göttingen
,
A. El-Armouche
1   Abteilung Pharmakologie, Universitätsmedizin Göttingen
› Author Affiliations
Further Information

Publication History

29 November 2011

09 February 2012

Publication Date:
10 April 2012 (online)

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Zusammenfassung

Der Tabakkonsum ist eines der bedeutendsten vermeidbaren Mortalitäts- und Morbiditätsrisiken. Folglich ist die Entwicklung neuer Strategien zur Raucherentwöhnung eine entscheidende medizinische Herausforderung. Vareniclin, ein Partialagonist am nikotinischen α4β2-Acetylcholinrezeptor, wurde speziell zur Raucherentwöhnung entwickelt. Die Wirksamkeit von Vareniclin wurde in unabhängigen Studien bewiesen, in denen die Substanz den bisher zur Raucherentwöhnung eingesetzten Medikamenten (Bupropion und Nikotinersatztherapie) signifikant überlegen war. Vareniclin wurde jedoch auch mit schwerwiegenden kardiovaskulären und neuropsychiatrischen Nebenwirkungen assoziiert. Dieser Beitrag beurteilt die aktuelle Studienlage zur Effektivität und insbesondere zur Sicherheit einer Vareniclin-Therapie zur Raucherentwöhnung.

Abstract

Smoking is one of the major avoidable risks for mortality and morbidity. Thus developing new strategies for smoking cessation is a crucial medical challenge. Varenicline is an α4β2 nicotinic acetylcholine receptor partial agonist developed especially for smoking cessation. Several trials proved the efficacy of varenicline and its superiority to other medications for smoking cessation (bupropion and nicotine replacement therapy). Varenicline was associated with severe cardiovascular and neuro-psychiatric side effects. This article discusses the current research data on efficacy and safety of varenicline therapy for smoking cessation.

Schlüsselwörter

Nikotinabhängigkeit - Raucherentwöhnung - Vareniclin - Nikotinrezeptor-Partialagonist

Keywords

nicotine dependence - smoking cessation - varenicline - nicotine receptor partial agonist
 

  • Literatur

  • 1 Champix® Fachinformation. Pfizer Limited. Stand: Juni 2011
    PubMed
  • 2 Coe JW, Brooks PR, Vetelino MG et al. Varenicline: An alpha4beta2 Nicotinic Receptor Partial Agonist for Smoking Cessation. J Med Chem 2005; 48: 3474-3477
    CrossrefPubMedGoogle Scholar
  • 3 Dani JA, Bertrand D. Nicotinic acetylcholine receptors and nicotinic cholinergic mechanisms of the central nervous system. Annu Rev Pharmacol Toxicol 2007; 47: 699-729
    CrossrefPubMedGoogle Scholar
  • 4 Deutsches Krebsforschungszentrum. Tabakatlas Deutschland 2009. http://www.dkfz.de/de/ Stand: 07.11.2011
    PubMedGoogle Scholar
  • 5 European Medicines Agency confirms positive benefit-risk balance for Champix 21 July 2011 EMA/579351/2011 Press Office; http://www.ema.europa.eu/ Stand: 25.11.2011
    PubMed
  • 6 FDA Drug Safety Newsletter 2009 Postmarket Review Volume 2, Number 1, 20092: 1; http://www.fda.gov/ Stand: 07.11.2011
    PubMed
  • 7 Gonzales D, Rennard SI, Nides M et al. Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA 2006; 296: 47-55
    CrossrefPubMedGoogle Scholar
  • 8 Gunnell D, Irvine D, Wise L et al. Varenicline and suicidal behaviour: a cohort study based on data from the General Practice Research Database. BMJ 2009; 339: b3805
    CrossrefPubMedGoogle Scholar
  • 9 Harrison-Woolrych M, Maggo S, Tan M et al. Cardiovascular events in patients taking varenicline: a case series from intensive postmarketing surveillance in New Zealand. Drug Saf 2012; 35: 33-43
    CrossrefPubMedGoogle Scholar
  • 10 Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev 2007; CD000031
    PubMedGoogle Scholar
  • 11 Institute for Safe Medication Practices. Strong Safety Signal Seen for New Varenicline Risks. http://www.ismp.org/docs/vareniclinestudy.asp Stand: 07.11.2011
    PubMedGoogle Scholar
  • 12 Jorenby DE, Hays JT, Rigotti NA et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 2006; 296: 56-63
    CrossrefPubMedGoogle Scholar
  • 13 Mattick RP, Breen C, Kimber J et al. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev 2009; CD002209
    PubMedGoogle Scholar
  • 14 Moore TJ, Furberg CD. Varenicline and suicide. Risk of psychiatric side effects with varenicline. BMJ 2009; 339: b4964
    CrossrefPubMedGoogle Scholar
  • 15 Nicorette® Fachinformation.. McNeil Consumer Healthcare GmbH. Stand: Juni 2008
    PubMed
  • 16 Rigotti NA, Pipe AL, Benowitz NL et al. Efficacy and safety of varenicline for smoking cessation in patients with cardiovascular disease: a randomized trial. Circulation 2010; 121: 221-229
    CrossrefPubMedGoogle Scholar
  • 17 Singh S, Loke YK, Spangler JG et al. Risk of serious adverse cardiovascular events associated with varenicline: a systematic review and meta-analysis. CMAJ 2011; 183: 1359-1366
    CrossrefPubMedGoogle Scholar
  • 18 Stead LF, Perera R, Bullen C et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2008; CD000146
    PubMedGoogle Scholar
  • 19 Tonstad S, Tønnesen P, Hajek P et al. Effect of maintenance therapy with varenicline on smoking cessation: a randomized controlled trial. JAMA 2006; 296: 64-71
    CrossrefPubMedGoogle Scholar
  • 20 Zyban® Fachinformation. . GlaxoSmithKline GmbH & Co. KG. Stand: Juli 2011
    PubMed