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Varenicline

Phase 3

Smoking Cessation | Small molecule | Psychiatry |Pfizer, Inc.|Last Updated: Apr 5, 2017

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLEDDMC
Total Trials12
Total Enrollment6,680

FDA Designations

No designations recorded

Clinical trial landscape

Varenicline · 16 trials · 5 indications

Phase 3 9Phase 2 2Phase 1 5
NCT00644969Smoking Cessation Study for Patients With Schizophrenia or Schizoaffective DisorderSmoking Cessation
COMPLETED128 Analytics
NCT00371813An Investigation of Effectiveness and Safety of Varenicline Tartrate in Helping People Quit SmokingSmoking Cessation
COMPLETED334 Analytics
NCT00282984Efficacy and Safety of Varenicline in Smokers With Cardiovascular Disease Who Wish to Quit SmokingSmoking Cessation
COMPLETED714 Analytics
NCT00141167A Twelve-Week Study of Varenicline for Safety and Efficacy in Comparison With Placebo for Smoking CessationSmoking Cessation
COMPLETED250 Analytics
NCT00143325An Open Label Study That Compares Varenicline to Transdermal Nicotine Patch for Smoking CessationSmoking Cessation
COMPLETED730 Analytics
NCT00143299A 52-Week Placebo-Controlled Study Evaluating the Safety of VareniclineSmoking Cessation
COMPLETED375 Analytics
NCT00143364A Twelve-Week Study of Varenicline for Safety and Efficacy in Comparison With Placebo and Zyban for Smoking CessationSmoking Cessation
COMPLETED1,005 Analytics
NCT00141206A Twelve-Week Study of Varenicline for Safety and Efficacy in Comparison With Placebo and Zyban for Smoking CessationSmoking Cessation
COMPLETED1,005 Analytics
NCT00143286A 52-Week Multicenter Study Evaluating the Safety and Efficacy of Varenicline for the Maintenance of Smoking CessationSmoking Cessation
COMPLETED2,000 Analytics
PHASE3COMPLETED
Smoking Cessation Study for Patients With Schizophrenia or Schizoaffective Disorder
Smoking CessationUnlock trial analytics
PHASE3COMPLETED
An Investigation of Effectiveness and Safety of Varenicline Tartrate in Helping People Quit Smoking
Smoking CessationUnlock trial analytics
PHASE3COMPLETED
Efficacy and Safety of Varenicline in Smokers With Cardiovascular Disease Who Wish to Quit Smoking
Smoking CessationUnlock trial analytics
PHASE3COMPLETED
A Twelve-Week Study of Varenicline for Safety and Efficacy in Comparison With Placebo for Smoking Cessation
Smoking CessationUnlock trial analytics
PHASE3COMPLETED
An Open Label Study That Compares Varenicline to Transdermal Nicotine Patch for Smoking Cessation
Smoking CessationUnlock trial analytics
PHASE3COMPLETED
A 52-Week Placebo-Controlled Study Evaluating the Safety of Varenicline
Smoking CessationUnlock trial analytics
PHASE3COMPLETED
A Twelve-Week Study of Varenicline for Safety and Efficacy in Comparison With Placebo and Zyban for Smoking Cessation
Smoking CessationUnlock trial analytics
PHASE3COMPLETED
A Twelve-Week Study of Varenicline for Safety and Efficacy in Comparison With Placebo and Zyban for Smoking Cessation
Smoking CessationUnlock trial analytics
PHASE3COMPLETED
A 52-Week Multicenter Study Evaluating the Safety and Efficacy of Varenicline for the Maintenance of Smoking Cessation
Smoking CessationUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
Baseline up to 30 days after last dose of study treatment or up to Week 16

AEs are any untoward medical occurrence in a clinical investigation participant administered a product or medical device. The event does not need to be causally related to the study treatment or usage. SAEs include any untoward medical occurrence that results in death, are life threatening, requires hospitalization or prolongation of hospitalization, results in disability or incapacity or are a congenital anomaly or birth defect in the offspring of a study participant. Lack of efficacy was to be reported as an AE when it was associated with an SAE.

Number of Participants With Psychiatric Adverse Events
Baseline up to Week 24

Psychiatric Adverse Event symptoms included, but were not restricted to, depression, anxiety, hostility, perceptual / thinking disturbance, suicidal ideation, or suicidal behavior based on clinical judgment and use of the Positive and Negative Syndrome Scale and Columbia Classification Algorithm of Suicide assessments.

Change From Baseline to Week 12 in Positive and Negative Syndrome Scale (PANSS): Total Score
Baseline to Week 12

PANSS includes 30 items rated on a 7-point scale (1=absent, 2=minimal, 3=mild, 4=moderate, 5=moderate severe, 6=severe, 7=extreme) organized as 7 positive symptom subscale items, 7 negative symptom subscale items and 16 general psychopathology items. Total scores range from 30 to 210 with higher scores indicating more extreme symptoms.

Change From Baseline to Week 24 in Positive and Negative Syndrome Scale (PANSS): Total Score
Baseline to Week 24

PANSS includes 30 items rated on a 7-point scale (1=absent, 2=minimal, 3=mild, 4=moderate, 5=moderate severe, 6=severe, 7=extreme) organized as 7 positive symptom subscale items, 7 negative symptom subscale items and 16 general psychopathology items. Total scores range from 30 to 210 with higher scores indicating more extreme symptoms.

Change From Baseline to Week 12 in Positive and Negative Syndrome Scale (PANSS): Positive Symptoms Score
Baseline to Week 12

PANSS includes 30 items rated on a 7-point scale (1=absent, 2=minimal, 3=mild, 4=moderate, 5=moderate severe, 6=severe, 7=extreme) organized as 7 positive symptom subscale items, 7 negative symptom subscale items and 16 general psychopathology items. Positive symptoms (productive symptoms) associated with schizophrenia (delusions, conceptual disorganization, and hallucinatory behavior) are rated on a scale from 1 (absent) to 7 (extreme); total positive subscale scores range from 7 to 49 with higher scores indicating more extreme symptoms.

Change From Baseline to Week 24 in Positive and Negative Syndrome Scale (PANSS): Positive Symptoms Score
Baseline to Week 24

PANSS includes 30 items rated on a 7-point scale (1=absent, 2=minimal, 3=mild, 4=moderate, 5=moderate severe, 6=severe, 7=extreme) organized as 7 positive symptom subscale items, 7 negative symptom subscale items and 16 general psychopathology items. Positive symptoms (productive symptoms) associated with schizophrenia (delusions, conceptual disorganization, and hallucinatory behavior) are rated on a scale from 1 (absent) to 7 (extreme); total positive subscale scores range from 7 to 49 with higher scores indicating more extreme symptoms.

Change From Baseline to Week 12 in Positive and Negative Syndrome Scale (PANSS): Negative Symptoms Score
Baseline to Week 12

PANSS includes 30 items rated on a 7-point scale (1=absent, 2=minimal, 3=mild, 4=moderate, 5=moderate severe, 6=severe, 7=extreme) organized as 7 positive symptom subscale items, 7 negative symptom subscale items and 16 general psychopathology items. Negative symptoms (deficit features) associated with schizophrenia (blunted affect, emotional withdrawal, poor rapport, and passive / apathetic social withdrawal) are rated on a scale from 1 (absent) to 7 (extreme); total negative subscale scores range from 7 to 49 with higher scores indicating more extreme symptoms.

Change From Baseline to Week 24 in Positive and Negative Syndrome Scale (PANSS): Negative Symptoms Score
Baseline to Week 24

PANSS includes 30 items rated on a 7-point scale (1=absent, 2=minimal, 3=mild, 4=moderate, 5=moderate severe, 6=severe, 7=extreme) organized as 7 positive symptom subscale items, 7 negative symptom subscale items and 16 general psychopathology items. Negative symptoms (deficit features) associated with schizophrenia (blunted affect, emotional withdrawal, poor rapport, and passive / apathetic social withdrawal) are rated on a scale from 1 (absent) to 7 (extreme); total negative subscale scores range from 7 to 49 with higher scores indicating more extreme symptoms.

Change From Baseline to Week 12 in Simpson Angus Rating Scale (SARS)
Baseline to Week 12

10-item rating scale to assess the severity of extrapyramidal symptoms rated on a 5-point scale 0 (normal) to 4 (highest severity). Items measured are gait, arm dropping, shoulder shaking, elbow rigidity, wrist rigidity, leg pendulousness, head dropping, glabella tap, tremor, and salivation. Global score calculated by summing individual item scores and dividing by the total number of items; range is 0 to 40 with higher scores indicating greater severity.

Change From Baseline to Week 24 in Simpson Angus Rating Scale (SARS)
Baseline to Week 24

10-item rating scale to assess the severity of extrapyramidal symptoms rated on a 5-point scale 0 (normal) to 4 (highest severity). Items measured are gait, arm dropping, shoulder shaking, elbow rigidity, wrist rigidity, leg pendulousness, head dropping, glabella tap, tremor, and salivation. Global score calculated by summing individual item scores and dividing by the total number of items; range is 0 to 40 with higher scores indicating greater severity.

Number of Participants With Suicidal Behavior and / or Ideation ("Yes" Response) on the Columbia Suicide Severity Rating Scale (C-SSRS) During the Treatment Phase
Week 1 to Week 12 (Treatment phase)

C-SSRS is a clinician rated assessment of suicidal behavior and / or intent categorized as: Suicidal behavior=a "yes" response to any of 5 suicidal behavior questions (preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide); Suicidal ideation=a "yes" response to any one of 5 suicidal ideation questions which includes wish to be dead, and 4 different categories of active suicidal ideation (thought, thought with method, thought with intent, thought with plan and intent).

Number of Participants With Suicidal Behavior or Suicical Ideation ("Yes" Response ) on the Columbia Suicide-Severity Rating Scale (C-SSRS) During the Post Treatment Phase
Week 13 to Week 24 (Post treatment phase)

C-SSRS is a clinician rated assessment of suicidal behavior and / or intent categorized as: Suicidal behavior=a "yes" response to any of 5 suicidal behavior questions (preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide); Suicidal ideation=a "yes" response to any one of 5 suicidal ideation questions which includes wish to be dead, and 4 different categories of active suicidal ideation (thought, thought with method, thought with intent, thought with plan and intent).

Number of Participants With Shift From Baseline to Week 12 in Clinical Global Impressions Scale-Severity (CGI-S) Score
Baseline (Bsl) to Week 12

CGI-S: 7-point clinician rated scale to assess severity of participant's current illness state; range: 1=normal, not ill at all, 2=borderline mentally ill, 3=mildly ill, 4=moderately ill, 5=markedly ill, 6=severely ill, 7=among the most extremely ill patients. Higher scores reflect higher severity of current illness states.

Number of Participants With Shift From Baseline to Week 24 in Clinical Global Impressions Scale-Severity (CGI-S) Score
Baseline to Week 24

CGI-S: 7-point clinician rated scale to assess severity of participant's current illness state; range: 1=normal, not ill at all, 2=borderline mentally ill, 3=mildly ill, 4=moderately ill, 5=markedly ill, 6=severely ill, 7=among the most extremely ill patients. Higher scores reflect higher severity of current illness states.

Number of Participants With Clinical Global Impression of Improvement Scale (CGI-I) Score at Week 1
Baseline, Week 1

CGI-I: 7-point clinician rated scale ranging from 1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, to 7=very much worse. Improvement is defined as a score of 1 (very much improved), 2 (much improved), or 3 (minimally improved) on the scale. Scores above 4 reflect worsening of illness state as compared to baseline.

Number of Participants With Clinical Global Impression of Improvement Scale (CGI-I) Score at Week 12
Baseline, Week 12

CGI-I: 7-point clinician rated scale ranging from 1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, to 7=very much worse. Improvement is defined as a score of 1 (very much improved), 2 (much improved), or 3 (minimally improved) on the scale. Scores above 4 reflect worsening of illness state as compared to baseline.

Number of Participants With Clinical Global Impression of Improvement Scale (CGI-I) Score at Week 24
Baseline, Week 24

CGI-I: 7-point clinician rated scale ranging from 1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, to 7=very much worse. Improvement is defined as a score of 1 (very much improved), 2 (much improved), or 3 (minimally improved) on the scale. Scores above 4 reflect worsening of illness state as compared to baseline.

To compare 12 weeks of treatment with varenicline 1 mg BID to placebo for smoking cessation, and to evaluate continuous abstinence from smoking for 12 weeks after the treatment period.
Number of Responders With Carbon Monoxide (CO) Confirmed 4-week Continuous Quit Rate (CQR) for Last 4 Weeks of Treatment (Trtmt)
weeks 9 through 12

Participants considered Responders (4-week CQR \<=10 parts per million \<ppm\>) through reports of cigarette or other nicotine use since last study visit, confirmed by measurement of end-expiratory exhaled carbon monoxide (CO). If any CO measurement at a particular timepoint was \>10 ppm, subject was considered to be Non-Responder at that timepoint.

4 week continuous quit rate ( 4 week CQR ) for weeks 9 -12
Continuous abstinence for the last 4 weeks of varenicline and NRT (Nicotine Replacement Therapy) treatment period
Summarization of safety data in smokers treated with either varenicline or placebo.
4 week Continuous Quit Rate ( 4 week CQR ) for Weeks 9 -12.
Continuous abstinence Weeks 13 -24.
Alzheimer's Disease Assessment Scale-Cognitive Subscale 75 (ADAS-Cog 75) at Week 6
Week 6

12-item scale to assess severity of cognitive impairment in AD. Items include word recall, naming objects and fingers, following commands, constructional praxis, ideational praxis, orientation, word recognition, spoken language ability, comprehension of spoken language, word finding difficulty in spontaneous speech, remembering test instructions, and concentration/distractibility. Total score range from 0-75 with 75 indicating worse cognition.

Carbon monoxide (CO)-confirmed 4-week continuous quit rate (4-week CQR) from Weeks 4 to 7.
Weeks 4-7
Rating Scale for Adhesive Residue (e.g., assesses how well the transdermal delivery system remains adhered to subject's skin)
24 hours per Arm
Rating Scale for Assessment of Application Site Dermal-Erythema, Edema, and Irritation (assesses skin irritation associated with varenicline transdermal delivery system)
6 days per Arm
Pharmacokinetic endpoints: plasma varenicline area under the curve (AUClast and AUCinf), maximum plasma concentration (Cmax), terminal half-life (t 1/2) and time of maximum plasma concentration (Tmax)
6 days per Arm
Tolerability and safety (adverse events, electrocardiogram, vital signs, clinical safety labs, self reported nausea visual analogue scales)
21 days
Steady state pharmacokinetics
21 days
Effects on cognition (computerized battery of cognitive tests)
21 days
Pharmacokinetic endpoints include varenicline area under the curve from 0-24 hours (AUC24), maximum plasma concentration (Cmax),
Day 1 and Day 14
Safety endpoints include evaluation of clinical safety laboratory tests, supine vital signs, triplicate 12-lead ECGs and adverse events.
up to 14 days
Time of maximum plasma concentration (Tmax) on Day 1 and Day 14
Day 1 and Day 14
Minimum plasma concentration (Cmin), terminal half life (t1/2), observed accumulation ratio (Rac), peak:trough fluctuation (%PTF) on Day 14 only.
Day 14
Pharmacokinetic parameters: Population mean estimate for apparent plasma clearance (CL/F), central volume of distribution (V2/F) and steady-state volume of distribution (Vss/F).
The PK parameters after a single dose and PK parameters after 7 days of multiple dosing respectively.

Secondary Endpoints

Number of Participants With 7-day Point Prevalence of Non-smoking at Week 12
Week 12
Number of Participants With 7-day Point Prevalence of Non-smoking at Week 24
Week 24
Number of Participants With at Least a 50 Percent (%) Reduction From Baseline to Week 12 and Week 24 in the Number of Cigarettes Smoked Per Day
Baseline, Week 12, Week 24
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL

Treatment Arms

ArmTypeDescription
Placebo ArmPLACEBO_COMPARATORRandomization 2:1 treatment to placebo
Treatment ArmACTIVE_COMPARATOR -
placeboPLACEBO_COMPARATOR -
vareniclineEXPERIMENTAL -
0.5 mg BIDEXPERIMENTAL -
Chantix immediate release tablet formulationACTIVE_COMPARATOR -
Varenicline transdermal delivery systemEXPERIMENTAL -
Weekly titrationACTIVE_COMPARATOR -
Two Week QDACTIVE_COMPARATOR -
Two Week BIDACTIVE_COMPARATOR -
Cohort 1OTHERSubjects will be randomized to receive either experimental drug (N=9) or matching placebo (N=3).
Cohort 2OTHERSubjects will be randomized to receive either experimental drug (N=9) or matching placebo (N=3).
Cohort 3OTHERSubjects will be randomized to receive either experimental drug (N=9) or matching placebo (N=3).
Optional Cohort 4OTHERSubjects will be randomized to receive either experimental drug (N=9) or matching placebo (N=3).
Optional Cohort 5OTHERSubjects will be randomized to receive either experimental drug (N=9) or matching placebo (N=3).

Interventions

NameTypeDescription
placeboDRUGRandomization 2:1 treatment to placebo
varenicline (CP-526,555)DRUGOne week of titration up to 1mg bid and 11 weeks of dosing at 1mg bid
Varenicline tartrateDRUG -
VareniclineDRUG1 mg twice daily by mouth for 12 weeks
varenicline free baseDRUGA single 2.0 mg dose of varenicline transdermal delivery system applied to the skin for a 24 hour period.
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Eligibility Criteria

Age Range18 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites14

Inclusion Criteria: * Have a diagnosis (using the SCID-I/P at screening visit) of schizophrenia or schizoaffective disorder and judged to be stable (without hospitalization or acute exacerbation and functioning in society) on psychiatric treatment for at least the past 6 month. * Current cigarette ...

Countries:United StatesCanadaChinaSingaporeThailandArgentinaAustraliaBrazilCzechiaDenmarkFranceGermanyGreeceMexicoNetherlandsSouth KoreaTaiwanUnited KingdomBelgiumNorwaySwedenJapan
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Frequently asked questions about Varenicline

What is Varenicline used for?

Varenicline is an investigational small molecule being studied for smoking cessation, smoking, healthy volunteers, and Alzheimer's disease. It is being developed by Pfizer, Inc. (NYSE: PFE) and is currently in Phase 2 clinical development for these indications.

What does Varenicline target?

Varenicline is a small molecule that acts on nicotinic acetylcholine receptors. It is being studied as a smoking cessation aid and for other neurological conditions. The drug's mechanism involves partial agonism at these receptors, which helps reduce cravings and withdrawal symptoms associated with smoking.

Who makes Varenicline?

Varenicline is being developed by Pfizer, Inc., a pharmaceutical company traded on the New York Stock Exchange under the ticker symbol PFE. The drug is currently in Phase 2 clinical trials for smoking cessation and other indications.

What phase is Varenicline in?

Varenicline is currently in Phase 2 clinical development. It has completed 12 clinical trials with a total enrollment of 6,680 participants. The drug is investigational and has not been approved by regulatory authorities for any indication.

What clinical trials is Varenicline in?

Varenicline has completed 12 clinical trials, including NCT00143325, a Phase 3 study comparing it to transdermal nicotine patch for smoking cessation with 730 participants. Other completed trials include NCT00463918, NCT00527150, and NCT00661765, which evaluated pharmacokinetics and formulations in smokers.

Is Varenicline the same as Chantix?

Varenicline is the generic name for the drug marketed as Chantix. The clinical trials listed use the name Varenicline, and the drug is being studied for smoking cessation and other conditions. Pfizer is the developer of this compound.