Effectiveness of Varenicline and Cytisine for Alcohol Use Reduction Among People With HIV and Substance Use A Randomized Clinical Trial

Source:

Tindle HA, Freiberg MS, Cheng DM, et al. Effectiveness of Varenicline and Cytisine for Alcohol Use Reduction Among People With HIV and Substance Use: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(8):e2225129. doi:10.1001/jamanetworkopen.2022.25129

Key Points

Question  Are varenicline and cytisine more efficacious than nicotine to treat alcohol and smoking among individuals who smoke daily, have HIV, and engage in risky drinking?

Findings  This randomized clinical trial of 400 individuals with HIV who engaged in risky drinking and daily smoking found that alcohol consumption at 3 months was decreased in all groups (active varenicline and placebo nicotine replacement therapy [NRT], placebo varenicline and active NRT, active cytisine and placebo NRT, and placebo cytisine and active NRT) but heavy drinking days did not differ significantly by group. Smoking abstinence at 6 months did not differ by group, but abstinence rates were high.

Meaning  This study found that varenicline and cytisine were not more efficacious than nicotine to treat risky drinking and smoking but that rates of behavior change for alcohol consumption and smoking were high in all treatment groups, suggesting a role for these medications in individuals who report risky drinking and smoking.