Trial Outcomes & Findings for Translational Neuropsychopharmacology Research of Nicotine Addiction (NCT NCT02723162)

NCT ID: NCT02723162

Last Updated: 2022-08-18

Results Overview

Measure the Effects of Varenicline and N-Acetylcysteine (NAC) on brain activation to smoking images while participants undergo Functional Magnetic Resonance (fMRI) Imaging. Mean percent signal change of fMRI BOLD in the insula and nucleus accumbens will be recorded during smoking images. The lower the BOLD signal response, the better the outcome, meaning reduced reactivity to smoking images.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

67 participants

Primary outcome timeframe

10 Days

Results posted on

2022-08-18

Participant Flow

Participant milestones

Participant milestones
Measure
VRN+ NAC
Titrated VRN up to 1mg BID with NAC at 1200mg BID for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment
NAC+ PBO
1200mg BID for 28 days plus VRN placebo for 28 days N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment Placebo: Matched placebo
VRN+ PBO
Titrated VRN up to 1mg BID with NAC placebo for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. Placebo: Matched placebo
PBO+PBO
Double placebo taken for 28 days Placebo: Matched placebo
Overall Study
STARTED
18
15
17
17
Overall Study
Day 10 fMRI Visit
15
11
14
15
Overall Study
COMPLETED
12
10
13
12
Overall Study
NOT COMPLETED
6
5
4
5

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Translational Neuropsychopharmacology Research of Nicotine Addiction

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Total
n=67 Participants
Total of all reporting groups
VRN+ NAC
n=18 Participants
Titrated VRN up to 1mg BID with NAC at 1200mg BID for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment
NAC+ PBO
n=15 Participants
1200mg BID for 28 days plus VRN placebo for 28 days N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment Placebo: Matched placebo
VRN+ PBO
n=17 Participants
Titrated VRN up to 1mg BID with NAC placebo for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. Placebo: Matched placebo
PBO+PBO
n=17 Participants
Double placebo taken for 28 days Placebo: Matched placebo
Age, Categorical
<=18 years
0 Participants
n=36 Participants
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
Age, Categorical
Between 18 and 65 years
67 Participants
n=36 Participants
18 Participants
n=93 Participants
15 Participants
n=4 Participants
17 Participants
n=27 Participants
17 Participants
n=483 Participants
Age, Categorical
>=65 years
0 Participants
n=36 Participants
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
Age, Continuous
39.7 years
STANDARD_DEVIATION 10.7 • n=36 Participants
43.6 years
STANDARD_DEVIATION 8.9 • n=93 Participants
35.1 years
STANDARD_DEVIATION 12.8 • n=4 Participants
42.4 years
STANDARD_DEVIATION 9.8 • n=27 Participants
37.1 years
STANDARD_DEVIATION 9.6 • n=483 Participants
Sex: Female, Male
Female
31 Participants
n=36 Participants
8 Participants
n=93 Participants
7 Participants
n=4 Participants
8 Participants
n=27 Participants
8 Participants
n=483 Participants
Sex: Female, Male
Male
36 Participants
n=36 Participants
10 Participants
n=93 Participants
8 Participants
n=4 Participants
9 Participants
n=27 Participants
9 Participants
n=483 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=36 Participants
0 Participants
n=93 Participants
2 Participants
n=4 Participants
1 Participants
n=27 Participants
0 Participants
n=483 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
63 Participants
n=36 Participants
18 Participants
n=93 Participants
13 Participants
n=4 Participants
16 Participants
n=27 Participants
16 Participants
n=483 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=36 Participants
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
1 Participants
n=483 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=36 Participants
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
Race (NIH/OMB)
Asian
0 Participants
n=36 Participants
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=36 Participants
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
Race (NIH/OMB)
Black or African American
20 Participants
n=36 Participants
6 Participants
n=93 Participants
8 Participants
n=4 Participants
3 Participants
n=27 Participants
3 Participants
n=483 Participants
Race (NIH/OMB)
White
44 Participants
n=36 Participants
12 Participants
n=93 Participants
7 Participants
n=4 Participants
12 Participants
n=27 Participants
13 Participants
n=483 Participants
Race (NIH/OMB)
More than one race
3 Participants
n=36 Participants
0 Participants
n=93 Participants
0 Participants
n=4 Participants
2 Participants
n=27 Participants
1 Participants
n=483 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=36 Participants
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
Region of Enrollment
United States
67 participants
n=36 Participants
18 participants
n=93 Participants
15 participants
n=4 Participants
17 participants
n=27 Participants
17 participants
n=483 Participants
Cigarettes Smoked Per Day
17.3 Cigarettes Per Day
STANDARD_DEVIATION 11.6 • n=36 Participants
16.8 Cigarettes Per Day
STANDARD_DEVIATION 12.6 • n=93 Participants
13.7 Cigarettes Per Day
STANDARD_DEVIATION 10.4 • n=4 Participants
17.3 Cigarettes Per Day
STANDARD_DEVIATION 11.4 • n=27 Participants
20.0 Cigarettes Per Day
STANDARD_DEVIATION 19.2 • n=483 Participants

PRIMARY outcome

Timeframe: 10 Days

Measure the Effects of Varenicline and N-Acetylcysteine (NAC) on brain activation to smoking images while participants undergo Functional Magnetic Resonance (fMRI) Imaging. Mean percent signal change of fMRI BOLD in the insula and nucleus accumbens will be recorded during smoking images. The lower the BOLD signal response, the better the outcome, meaning reduced reactivity to smoking images.

Outcome measures

Outcome measures
Measure
VRN+ NAC
n=15 Participants
Titrated VRN up to 1mg BID with NAC at 1200mg BID for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment
NAC+ PBO
n=11 Participants
1200mg BID for 28 days plus VRN placebo for 28 days N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment Placebo: Matched placebo
VRN+ PBO
n=14 Participants
Titrated VRN up to 1mg BID with NAC placebo for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. Placebo: Matched placebo
PBO+PBO
n=15 Participants
Double placebo taken for 28 days Placebo: Matched placebo
Percent Change in Blood Oxygen Level Dependent (BOLD) Signal Response
Insula
-0.09 Percentage change
Interval -1.14 to 0.77
1.07 Percentage change
Interval 0.39 to 1.41
0.08 Percentage change
Interval -0.36 to 0.33
1.19 Percentage change
Interval 0.78 to 2.84
Percent Change in Blood Oxygen Level Dependent (BOLD) Signal Response
Nucleus Accumbens
0.11 Percentage change
Interval -0.25 to 0.67
0.91 Percentage change
Interval -0.15 to 1.81
0.12 Percentage change
Interval -0.81 to 1.1
1.43 Percentage change
Interval 0.94 to 2.25

PRIMARY outcome

Timeframe: Baseline to day 10

Measure the effects of Varenicline and N-Acetylcysteine on resting-state functional connectivity while participants undergo fMRI. Fisher transformed correlation (rZ) scores will be recorded between medial prefrontal cortex and ventral striatum during a resting state scan. The higher the rZ score, the better the outcome, meaning stronger functional connectivity. rZ scores range from -1 to 1. The rZ-score central value is analogous to a central value to of a Z-score of 0, representing the population mean.

Outcome measures

Outcome measures
Measure
VRN+ NAC
n=16 Participants
Titrated VRN up to 1mg BID with NAC at 1200mg BID for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment
NAC+ PBO
n=14 Participants
1200mg BID for 28 days plus VRN placebo for 28 days N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment Placebo: Matched placebo
VRN+ PBO
n=11 Participants
Titrated VRN up to 1mg BID with NAC placebo for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. Placebo: Matched placebo
PBO+PBO
n=15 Participants
Double placebo taken for 28 days Placebo: Matched placebo
rZ Change Score in Resting State Functional Connectivity From Baseline
.297 Fisher Z
Standard Error .053
.060 Fisher Z
Standard Error .042
.181 Fisher Z
Standard Error .053
.191 Fisher Z
Standard Error .058

SECONDARY outcome

Timeframe: 28 Days

Population: Analysis population consists of randomized participants that had data available at study day 7 or beyond.

Measure the effects of Varenicline and N-Acetylcysteine on smoking behavior over the course of the study

Outcome measures

Outcome measures
Measure
VRN+ NAC
n=15 Participants
Titrated VRN up to 1mg BID with NAC at 1200mg BID for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment
NAC+ PBO
n=13 Participants
1200mg BID for 28 days plus VRN placebo for 28 days N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment Placebo: Matched placebo
VRN+ PBO
n=14 Participants
Titrated VRN up to 1mg BID with NAC placebo for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. Placebo: Matched placebo
PBO+PBO
n=16 Participants
Double placebo taken for 28 days Placebo: Matched placebo
Number of Cigarettes Smoked Per Day
5.3 Cigarettes per day
Standard Deviation 5.5
4.0 Cigarettes per day
Standard Deviation 4.8
5.3 Cigarettes per day
Standard Deviation 3.9
5.0 Cigarettes per day
Standard Deviation 4.5

Adverse Events

VRN+ NAC

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

NAC+ PBO

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

VRN+ PBO

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

PBO+PBO

Serious events: 2 serious events
Other events: 8 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
VRN+ NAC
n=18 participants at risk
Titrated VRN up to 1mg BID with NAC at 1200mg BID for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment
NAC+ PBO
n=15 participants at risk
1200mg BID for 28 days plus VRN placebo for 28 days N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment Placebo: Matched placebo
VRN+ PBO
n=17 participants at risk
Titrated VRN up to 1mg BID with NAC placebo for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. Placebo: Matched placebo
PBO+PBO
n=17 participants at risk
Double placebo taken for 28 days Placebo: Matched placebo
Injury, poisoning and procedural complications
Upper Limb Fracture
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
Hepatobiliary disorders
Choleithiasis (worsening)
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days

Other adverse events

Other adverse events
Measure
VRN+ NAC
n=18 participants at risk
Titrated VRN up to 1mg BID with NAC at 1200mg BID for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment
NAC+ PBO
n=15 participants at risk
1200mg BID for 28 days plus VRN placebo for 28 days N-Acetylcysteine (NAC): NAC will be dosed at 1200 mg twice daily throughout the 28-day active treatment Placebo: Matched placebo
VRN+ PBO
n=17 participants at risk
Titrated VRN up to 1mg BID with NAC placebo for 28 days Varenicline (VRN): VRN will be provided at the standard recommended dose (0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter for the remaining 21 days of active treatment. Placebo: Matched placebo
PBO+PBO
n=17 participants at risk
Double placebo taken for 28 days Placebo: Matched placebo
Respiratory, thoracic and mediastinal disorders
Allergic Rhinitis
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
Gastrointestinal disorders
Nausea
0.00%
0/18 • 35 days
26.7%
4/15 • Number of events 4 • 35 days
0.00%
0/17 • 35 days
23.5%
4/17 • Number of events 5 • 35 days
Vascular disorders
Flushing
0.00%
0/18 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Nervous system disorders
Headache
5.6%
1/18 • Number of events 1 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
5.9%
1/17 • Number of events 2 • 35 days
Injury, poisoning and procedural complications
Eye Injury
0.00%
0/18 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Gastrointestinal disorders
Food Poisoning
5.6%
1/18 • Number of events 1 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Psychiatric disorders
Depressed Mood
5.6%
1/18 • Number of events 1 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
Psychiatric disorders
Anxiety (Worsening)
0.00%
0/18 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
11.8%
2/17 • Number of events 2 • 35 days
General disorders
Irritability
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
General disorders
Increased Energy
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
General disorders
Constipation
5.6%
1/18 • Number of events 1 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Infections and infestations
Sinusitis
5.6%
1/18 • Number of events 1 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Psychiatric disorders
Insomnia
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
11.8%
2/17 • Number of events 2 • 35 days
Injury, poisoning and procedural complications
Post Operative Pain
0.00%
0/18 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Skin and subcutaneous tissue disorders
Rash, Generalized
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
Infections and infestations
Subcutaneous Abscess
0.00%
0/18 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Injury, poisoning and procedural complications
Ligament Sprain
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
Psychiatric disorders
Agitation
0.00%
0/18 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Psychiatric disorders
Somnambulism
5.6%
1/18 • Number of events 1 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Nervous system disorders
Headache (worsening)
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
Gastrointestinal disorders
Flatulence
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
11.8%
2/17 • Number of events 2 • 35 days
Infections and infestations
Bronchitis
5.6%
1/18 • Number of events 1 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Gastrointestinal disorders
Dyspepsia
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 2 • 35 days
Nervous system disorders
Poor Quality Sleep
5.6%
1/18 • Number of events 1 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Infections and infestations
Gastroenteritis
0.00%
0/18 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
General disorders
Fatigue
5.6%
1/18 • Number of events 1 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Respiratory, thoracic and mediastinal disorders
Throat Irritation
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
Injury, poisoning and procedural complications
Post-Traumatic Pain (Worsening)
0.00%
0/18 • 35 days
6.7%
1/15 • Number of events 1 • 35 days
0.00%
0/17 • 35 days
0.00%
0/17 • 35 days
Psychiatric disorders
Psychological Trauma
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
Gastrointestinal disorders
Vomiting
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days
Metabolism and nutrition disorders
Increased Appetite
0.00%
0/18 • 35 days
0.00%
0/15 • 35 days
0.00%
0/17 • 35 days
5.9%
1/17 • Number of events 1 • 35 days

Additional Information

Dr. Kevin Gray

Medical University of South Carolina

Phone: 843-792-9162

Results disclosure agreements

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