NCT00937235

Brief Summary

This study will examine the effect of combining prolonged exposure, a cognitive-behavioral treatment program for post-traumatic stress disorder (PTSD) with medication (varenicline) and counseling treatments for smoking cessation. Subjects will be randomly assigned to a 3-month treatment of either: 1) varenicline and smoking cessation counseling alone, or 2) prolonged exposure, varenicline, and smoking cessation counseling. Assessments will be completed at the end of treatment and 6-month follow-up. We hypothesize that, at the end of treatment and at follow-up, abstinence rates and decrease in cigarettes smoked will be greater among participants who receive the combined treatment for both PTSD and smoking.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
142

participants targeted

Target at P75+ for phase_2

Timeline
Completed

Started Jan 2009

Longer than P75 for phase_2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2009

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

July 8, 2009

Completed
2 days until next milestone

First Posted

Study publicly available on registry

July 10, 2009

Completed
6.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2015

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2015

Completed
1.8 years until next milestone

Results Posted

Study results publicly available

September 7, 2017

Completed
Last Updated

November 14, 2017

Status Verified

October 1, 2017

Enrollment Period

6.9 years

First QC Date

July 8, 2009

Results QC Date

March 28, 2017

Last Update Submit

October 11, 2017

Conditions

Keywords

Smoking CessationAnxietyBehavior TherapyVarenicline

Outcome Measures

Primary Outcomes (1)

  • Number of Participants With 7-day Point Prevalence Smoking Abstinence

    Number of participants reporting seven-day point prevalence abstinence (PPA), which was defined as self-reported abstinence for 7 days prior to the assessment, serum cotinine level of \<15ng/ml, and CO \< 10 ppm.

    At 3-month follow-up (6-month post-quit day)

Secondary Outcomes (7)

  • Blood Serum Cotinine

    At end of 3-month follow-up

  • Posttraumatic Symptom Scale Interview (PSS-I) at Post-Treatment

    Post-treatment, occurring 12 weeks after the start of treatment (week 0)

  • Posttraumatic Symptom Scale Interview (PSS-I) Total Score at 3-Month Follow-Up

    3-month follow-up

  • Hamilton Depression Scale (HAM-D) Total Score at Post-Treatment

    Post-Treatment assessment, occurring 12 weeks after the start of treatment (week 0)

  • Hamilton Depression Scale (HAM-D) Total Score at 3-Month Follow-Up

    3-month follow-up

  • +2 more secondary outcomes

Study Arms (2)

Integrated Treatment

EXPERIMENTAL

Prolonged Exposure + Varenicline + Medication Management Counseling

Drug: VareniclineBehavioral: Medication Management CounselingBehavioral: Prolonged Exposure

Varenicline

ACTIVE COMPARATOR

Varenicline + Medication Management Counseling

Drug: VareniclineBehavioral: Medication Management Counseling

Interventions

1 mg tablets, orally, twice daily x 12 weeks

Also known as: Chantix
Integrated TreatmentVarenicline

15-minutes weekly counseling x 12 weeks, focused on medication adherence and smoking cessation

Integrated TreatmentVarenicline

75-90 minute weekly psychotherapy sessions x 12 weeks, focused on gradually confronting distressing trauma-related memories and reminders

Also known as: Cognitive-Behavioral Therapy
Integrated Treatment

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Male or female treatment-seeking cigarette smokers between 18-75 years old who smoke an average of ≥10 cigarettes/day during past year;
  • Current diagnosis of chronic PTSD (symptom duration \> 3 months) with clinically significant trauma-related symptoms (PSS-I \>= 20)
  • Live a commutable distance to the University of Pennsylvania and agree to follow-up visits;
  • Agree not to use other forms of smoking cessation treatment or treatment for PTSD during the study period;
  • If taking SRIs or other medications at intake, have been on stable medication and dose regimen for past 3 months and agree to maintain current regimen if possible;
  • Demonstrate the capacity to provide informed consent;
  • Speak and read English.

You may not qualify if:

  • History of drug or alcohol abuse or dependence in past 3 months or any unwillingness to not smoke marijuana during the first 13 weeks of the study;
  • Current and continuing intimate relationship with a physically or sexually abusive partner;
  • Current suicidal ideation with intent and/or plan that, in the judgment of the investigator, should be the focus of treatment;
  • Prior serious suicide attempt, as judged by the evaluator to have a high degree of lethality;
  • Current or past history of psychosis (bipolar disorder or schizophrenia);
  • History of significant cardiovascular disease or uncontrolled hypertension in past 6 months;
  • Women who are pregnant, likely to become pregnant (i.e., sexually active and not using contraception), or nursing.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Pennsylvania School of Medicine, Dept of Psychiatry, Center for Treatment and Study of Anxiety

Philadelphia, Pennsylvania, 19104, United States

Location

Related Links

MeSH Terms

Conditions

Cigarette SmokingTobacco Use DisorderStress Disorders, Post-TraumaticSmoking CessationAnxiety Disorders

Interventions

VareniclineCognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Tobacco SmokingSmokingBehaviorTobacco UseSubstance-Related DisordersChemically-Induced DisordersMental DisordersStress Disorders, TraumaticTrauma and Stressor Related DisordersHealth Behavior

Intervention Hierarchy (Ancestors)

BenzazepinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsQuinoxalinesBehavior TherapyPsychotherapyBehavioral Disciplines and Activities

Limitations and Caveats

1. PPA verified by CO/cotinine was only assessed at two time-points (post-treatment, and follow-up) 2. medication adherence for varenicline was measured using pill count by the study nurse

Results Point of Contact

Title
Dr. Edna Foa
Organization
University of Pennsylvania

Study Officials

  • Edna B Foa, Ph.D.

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 8, 2009

First Posted

July 10, 2009

Study Start

January 1, 2009

Primary Completion

December 1, 2015

Study Completion

December 1, 2015

Last Updated

November 14, 2017

Results First Posted

September 7, 2017

Record last verified: 2017-10

Locations