RecruitingPhase 3NCT04176172

Optimizing Tobacco Use Treatment for PLWHA

Testing Novel Pharmacogenetic and Adherence Optimization Treatments to Improve the Effectiveness of Smoking Cessation Treatments for Smokers With HIV


Sponsor

University of Pennsylvania

Enrollment

340 participants

Start Date

Feb 17, 2020

Study Type

INTERVENTIONAL

Conditions

Summary

The advent of anti-retroviral therapy (ART) for people living with HIV/AIDS (PLWHA) substantially improved life expectancy but has also led to the critical need to address modifiable risk factors associated with cancer and cardiovascular disease, such as tobacco smoking. HIV-infected smokers lose more life-years due to tobacco use than they do to their HIV infection. There have been relatively few studies of tobacco use treatments for PLWHA and systematic reviews show that there are insufficient data to conclude that tobacco dependence interventions that are efficacious in the general population are efficacious for PLWHA. Further, many studies in this area have lacked randomization and a control group, infrequently used an intent-to-treat (ITT) approach and biological verification of tobacco abstinence, and lacked post-treatment follow-up.10 What investigators do know thus far is that behavioral interventions and the nicotine patch yield moderate effects on cessation; and 2 recent placebo-controlled trials - one in France and one by this lab - found that varenicline is safe and effective for treating tobacco use among PLWHA, but yield quit rates that are substantially lower than those reported in the general population. Thus, there is a critical need to rigorously test novel ways to optimize tobacco cessation treatment for smokers with HIV.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is testing a combined approach to help people living with HIV who smoke cigarettes quit smoking. It compares standard nicotine replacement with the prescription medication varenicline (Chantix), along with behavioral counseling. **You may be eligible if...** - You are over 18 years old - You are HIV-positive with a controlled viral load (under 1,000 copies/mL) - You currently smoke cigarettes daily - You live near one of the study sites and plan to stay in the area for at least 7 months **You may NOT be eligible if...** - You have untreated or unstable mental health conditions (depression, psychosis, or bipolar disorder) - You are currently at risk of suicide - You have untreated substance use disorder - You are pregnant or planning to become pregnant during the study Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGVarenicline

Participants will receive open-label varenicline for 12 weeks.

DRUGNicotine patch

Participants will receive open-label nicotine patch for 12 weeks. (Participants in the NMR-tailored treatment arms will receive either varenicline OR patch; they will not receive both)

BEHAVIORALStandard treatment

Standard behavioral smoking cessation treatment is an effective treatment for nicotine dependence. Treatment focuses on self-monitoring of smoking behavior, identifying smoking triggers and alternative trigger management strategies, relaxation, social support for non-smoking, and relapse prevention. Participants will receive up to 5 therapy sessions (2 in person, 3 over the phone) over 8 weeks.

BEHAVIORALStandard treatment + Managed Problem Solving (MAPS) adherence intervention

Standard behavioral smoking cessation treatment is an effective treatment for nicotine dependence. Treatment focuses on self-monitoring of smoking behavior, identifying smoking triggers and alternative trigger management strategies, relaxation, social support for non-smoking, and relapse prevention. Managed Problem Solving (MAPS) is a therapeutic process that involves the systematic delineation of a participant's medication adherence problems and construction of a series of individualized solutions that therapists and participants explore together. Participants will receive up to 5 therapy sessions (2 in person, 3 over the phone) over 8 weeks. The first session will directly address potential medication adherence barriers, and therapist and participant will collaboratively brainstorm ways to overcome these barriers.


Locations(2)

Northwestern University

Chicago, Illinois, United States

University of Pennsylvania

Philadelphia, Pennsylvania, United States

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NCT04176172


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