Varenicline–lorcaserin combo falls short of preventing weight gain after quitting smoking
12 Oct 2022
Treatment with the combination of varenicline and lorcaserin does not appear to benefit people who have long ceased cigarette smoking in terms of suppressing increases in weight and waist circumference, according to the results of a phase II trial.
The trial included 84 adults who had been smoking at least 10 cigarettes/day for the past 6 months and had a body mass index (BMI) of 27–34.9 kg/m2. They were randomized to receive varenicline for 12 weeks plus either lorcaserin (n=40) or placebo (n=44) for 24 weeks. The primary endpoints were weight and waist circumference changes at 12 and 24 weeks in participants meeting criteria for prolonged smoking abstinence.
The participants had a mean age of 42.3 years, with most being White (92.9 percent) and women (65.5 percent). The average cigarettes smoked per day was 17.5, while the average Fagerström Test for Nicotine Dependence score was 4.9.
Thirty-nine participants (46 percent) met the criteria for prolonged smoking abstinence at 12 weeks and 21 (25 percent) at 24 weeks. Lorcaserin had the same treatment effect as placebo at 12 weeks (weight difference, −0.7 kg, 90 percent confidence interval [CI], −2.6 to 1.1; p=0.51; waist circumference difference, −1.9 cm, 90 CI, −4.2 to 0.5; p=0.18; or BMI difference, −0.4 kg/m2, 90 percent CI, −1.1 to 0.3; p=0.33).
Likewise, there was no significant difference in treatment effect seen between lorcaserin and placebo at 24 weeks (weight, 1.4 kg, 90 percent CI, −3.8 to 6.7; p=0.65; waist circumference, −0.9 cm, 90 percent CI, −5.8 to 4.0; p=0.75; BMI, 0.29 kg/m2, 90 percent CI, −1.5 to 2.12; p=0.79).
The findings should be interpreted with caution, according to researchers, due to the early termination of the study owing to the removal of lorcaserin from the market and the possibility that the trial was underpowered for the present analysis.