GEMNIC: Gemfibrozil for Nicotine Smoking Cessation
Study Details
Study Description
Brief Summary
This project will test whether gemfibrozil, a well-studied medication for high cholesterol, will help people stop smoking nicotine cigarette smoking. The study will also test whether gemfibrozil decrease cravings for cigarette and the desire to smoke.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Phase 2 |
Detailed Description
This is a pilot clinical trial examining the feasibility and efficacy of gemfibrozil treatment for smoking cessation. Adults with a desire to quit nicotine cigarette smoking will be recruited. Eligible participants will be randomly divided into two groups: those who receive gemfibrozil and waitlist controls. Screening will be conducted with a brief phone screen followed by a longer screening visit for those who qualify. During the screening visit, all study participants will provide demographic information and will be interviewed regarding smoking history. Procedures performed during the screening visit include a blood draw, urine pregnancy test, physical exam, clinical psychiatric interview, and measurement of exhaled carbon monoxide (CO). At baseline, participants will complete the Heavy Smoking Index (HSI) and the Brief Questionnaire of Smoking Urges (QSU-Brief). Participants will also complete the Quick Inventory of Depressive Symptoms-Self Rated (QIDS-SR) to assess symptoms of depression and changes in mood associated with smoking cessation will be assessed with the Concise Associated Symptoms Tracking (CAST) scale . Participants will work with the research clinician to set a target quit date within one week of the baseline session, and all participants will be provided written materials with guidance for smoking cessation as part of a smoking cessation counseling session. All participants will attend visits at the research clinic at 3 days and 4 weeks from target quit date to assess safety, adherence, and smoking status; participants will also receive additional smoking cessation counseling. Smoking status will be determined with exhaled breath CO and a single item questionnaire regarding the number of cigarettes smoked since target quit date and symptoms of depression and mood changes will again be measured. Medication side effects will be quantified using the Frequency, Intensity, and Burden of Side Effects Rating (FIBSER) scale. The final study visit will occur at 8 weeks after target quit date for completion of the HSI, QIDS-SR, CAST, FIBSER, exhaled breath CO, QSU-Brief, and smoking self-report.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Gemfibrozil Participants in this arm will receive smoking cessation counseling and will be provided gemfibrozil 600 mg twice daily by mouth for 9 weeks, starting one week prior to target quit date and ending with study completion |
Drug: Gemfibrozil
FDA Approved Drug(s)/Biologic(s) (study use is not an FDA-approved use)
Other Names:
Behavioral: smoking cessation counseling
smoking cessation counseling
|
Other: Waitlist Participants in this arm will receive the smoking cessation counseling but will not receive medication. After completing the trial without medication, participants who continue to smoke and have a desire to quit may choose to enter the gemfibrozil arm. |
Behavioral: smoking cessation counseling
smoking cessation counseling
|
Outcome Measures
Primary Outcome Measures
- Exhaled Carbon Monoxide (CO) [8 weeks after target quit date]
Exhaled carbon monoxide change from baseline to last available visit.
Secondary Outcome Measures
- Heaviness of Smoking Index [8 weeks after target quit date]
The outcome measure was Heaviness of Smoking Index at exit. The Heaviness of Smoking Index is a two-item scale, with scores on each item rated on a 1-4 likert scale. The total score of the measure ranges from 2-8, with higher scores indicating worse outcome.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age 18-64 years
-
Meet DSM-5 criteria for tobacco use disorder based on cigarette use
-
Desire to quit smoking
-
Able to complete assessments and interview in English
Exclusion Criteria:
-
Psychiatric co-morbidity posing safety risk, including current suicidality or psychosis as assessed on clinical interview
-
Concurrent use of a statin medication (HMG-CoA reductase inhibitor),anticoagulant, or repaglinide
-
Concurrent use of any FDA-approved medication for smoking cessation
-
Use of any form of tobacco or nicotine (including vaporizer) other than cigarette smoking
-
Any DSM-5 substance use disorder other than nicotine use disorder
-
History of intolerance to any fibrate medication
-
History of gallbladder disease and cholestectomy has not been performed
-
Baseline liver function tests > twice the upper limit of normal
-
Severe impairment of renal function (baseline serum creatinine ≥ 2 mg/dL)
-
Currently pregnant or nursing
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Parkland Memorial Hospital | Dallas | Texas | United States | 75235 |
Sponsors and Collaborators
- University of Texas Southwestern Medical Center
Investigators
- Principal Investigator: Madhukar Trivedi, MD, University of Texas Southwestern Medical Center
Study Documents (Full-Text)
None provided.More Information
Publications
- Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, Markowitz JC, Ninan PT, Kornstein S, Manber R, Thase ME, Kocsis JH, Keller MB. The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003 Sep 1;54(5):573-83. Erratum in: Biol Psychiatry. 2003 Sep 1;54(5):585.
- Trivedi MH, Wisniewski SR, Morris DW, Fava M, Kurian BT, Gollan JK, Nierenberg AA, Warden D, Gaynes BN, Luther JF, Rush AJ. Concise Associated Symptoms Tracking scale: a brief self-report and clinician rating of symptoms associated with suicidality. J Clin Psychiatry. 2011 Jun;72(6):765-74. doi: 10.4088/JCP.11m06840.
- Wisniewski SR, Rush AJ, Balasubramani GK, Trivedi MH, Nierenberg AA; STARD Investigators. Self-rated global measure of the frequency, intensity, and burden of side effects. J Psychiatr Pract. 2006 Mar;12(2):71-9.
- STU 072014-088
Study Results
Participant Flow
Recruitment Details | |
---|---|
Pre-assignment Detail |
Arm/Group Title | Waitlist | Gemfibrozil |
---|---|---|
Arm/Group Description | Participants placed on waitlist for medication, otherwise completed study procedures | Received gemfibrozil tablets |
Period Title: Overall Study | ||
STARTED | 8 | 8 |
COMPLETED | 4 | 3 |
NOT COMPLETED | 4 | 5 |
Baseline Characteristics
Arm/Group Title | Waitlist | Gemfibrozil | Total |
---|---|---|---|
Arm/Group Description | Participants placed on waitlist for medication, otherwise completed study procedures | Received gemfibrozil tablets | Total of all reporting groups |
Overall Participants | 8 | 8 | 16 |
Age (Count of Participants) | |||
<=18 years |
0
0%
|
0
0%
|
0
0%
|
Between 18 and 65 years |
8
100%
|
8
100%
|
16
100%
|
>=65 years |
0
0%
|
0
0%
|
0
0%
|
Age (Years) [Mean (Standard Deviation) ] | |||
Mean (Standard Deviation) [Years] |
25.25
(14.12)
|
37.50
(22.02)
|
31.38
(18.07)
|
Sex: Female, Male (Count of Participants) | |||
Female |
6
75%
|
6
75%
|
12
75%
|
Male |
2
25%
|
2
25%
|
4
25%
|
Region of Enrollment (Count of Participants) | |||
United States |
8
100%
|
8
100%
|
16
100%
|
Outcome Measures
Title | Exhaled Carbon Monoxide (CO) |
---|---|
Description | Exhaled carbon monoxide change from baseline to last available visit. |
Time Frame | 8 weeks after target quit date |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Gemfibrozil | Waitlist |
---|---|---|
Arm/Group Description | Participants in this arm will receive smoking cessation counseling and will be provided gemfibrozil 600 mg twice daily by mouth for 9 weeks, starting one week prior to target quit date and ending with study completion Gemfibrozil: FDA Approved Drug(s)/Biologic(s) (study use is not an FDA-approved use) smoking cessation counseling: smoking cessation counseling | Participants in this arm will receive the smoking cessation counseling but will not receive medication. After completing the trial without medication, participants who continue to smoke and have a desire to quit may choose to enter the gemfibrozil arm. smoking cessation counseling: smoking cessation counseling |
Measure Participants | 8 | 8 |
Mean (Standard Deviation) [Parts p/million] |
10.88
(12.63)
|
21.63
(22.04)
|
Title | Heaviness of Smoking Index |
---|---|
Description | The outcome measure was Heaviness of Smoking Index at exit. The Heaviness of Smoking Index is a two-item scale, with scores on each item rated on a 1-4 likert scale. The total score of the measure ranges from 2-8, with higher scores indicating worse outcome. |
Time Frame | 8 weeks after target quit date |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Waitlist | Gemfibrozil |
---|---|---|
Arm/Group Description | Participants placed on waitlist for medication, otherwise completed study procedures | Received gemfibrozil tablets |
Measure Participants | 8 | 8 |
Mean (Standard Deviation) [score on a scale] |
1.25
(1.04)
|
1.63
(1.30)
|
Adverse Events
Time Frame | ||||
---|---|---|---|---|
Adverse Event Reporting Description | ||||
Arm/Group Title | Gemfibrozil | Waitlist | ||
Arm/Group Description | Participants in this arm will receive smoking cessation counseling and will be provided gemfibrozil 600 mg twice daily by mouth for 9 weeks, starting one week prior to target quit date and ending with study completion Gemfibrozil: FDA Approved Drug(s)/Biologic(s) (study use is not an FDA-approved use) smoking cessation counseling: smoking cessation counseling | Participants in this arm will receive the smoking cessation counseling but will not receive medication. After completing the trial without medication, participants who continue to smoke and have a desire to quit may choose to enter the gemfibrozil arm. smoking cessation counseling: smoking cessation counseling | ||
All Cause Mortality |
||||
Gemfibrozil | Waitlist | |||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | / (NaN) | / (NaN) | ||
Serious Adverse Events |
||||
Gemfibrozil | Waitlist | |||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | 0/8 (0%) | 0/8 (0%) | ||
Other (Not Including Serious) Adverse Events |
||||
Gemfibrozil | Waitlist | |||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | 1/8 (12.5%) | 1/8 (12.5%) | ||
Gastrointestinal disorders | ||||
Abdominal pain | 1/8 (12.5%) | 1 | 0/8 (0%) | 0 |
Skin and subcutaneous tissue disorders | ||||
Arm bruising | 0/8 (0%) | 0 | 1/8 (12.5%) | 1 |
Limitations/Caveats
More Information
Certain Agreements
All Principal Investigators ARE employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Name/Title | Principal Investigator |
---|---|
Organization | University of Texas Southwestern Medical Center |
Phone | 2146480188 |
madhukar.trivedi@UTSouthwestern.edu |
- STU 072014-088