Download Frank Vocci - Consumer Demand

New Pharmacotherapies for
Assisting Smokers in Their
Cessation Efforts
Frank Vocci, Ph.D.
Director, DPMCDA
December 7, 2005
Varenicline
• Partial agonist at the 4ß2 nicotine
receptor
• Partial agonists have some effects like
nicotine but can also act like
antagonists
• A dual mechanism of action is
proposed:
– Partial nicotine-like effects
– Nicotine blockade from cigarette smoking
Varenicline
Varenicline Phase II TrialsTonstad study
Drug
12 Week
Quit Rate %
52 Week
Quit Rate %
placebo
18
10
Bupropion
30
16
Varenicline
44
22
Rimonabant
• CB1 inverse agonist/ antagonist
• Stratus-US Study ( unpublished)
• Quit rates in the 20 mg group were double
that of placebo
• Weight gain in the 20 mg group was 0.4 kg
for 12 weeks versus 3.6 kg for placebo
• The 20 mg group also had attenuated weight
gain 1.5 kg versus and additional 3.5 kg for
placebo
Rimonabant
• May be sought after by smokers who
want to quit but don’t want to gain
weight
• Could be tested with other therapies,
especially NRT for additive effects
• Has other metabolic effects which can
independently reduce cardiovascular
disease risk
Nicotine Vaccine
• Being produced by three companies
• Potential indications:
– Aid to cessation
– Prevention of relapse
– And prevention of smoking
Nicotine Vaccine
Nicotine Vaccine
Nicotine Vaccine Blocks
Nicotine Self-Administration
New Therapies
• Offer new prospects for smokers
looking for an assist to quit smoking
• Each may have distinct advantages
• The vaccine may be useful for relapse
prevention
• Other medications are also being
developed