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Varenicline nears first-line status

Varenicline has taken another step towards acceptance as a first-line treatment with a gold standard review concluding it is more effective than bupropion.

A NICE assessment of the nicotine receptor partial agonist is now under way.

Reviewers for the Cochrane Tobacco Addition Group said they were surprised by the relatively poor performance of bupropion in their study, but nonetheless varenicline appeared to be effective.

Kate Cahill, the Cochrane review group co-ordinator based at the department of primary health care, University of Oxford, told Pulse: 'It's certainly very promising.

'Really in terms of affecting GPs it's what NICE comes up with that makes the big difference. I would be very surprised if they didn't make it a first-line treatment.'

The review found varenicline increased the likelihood of continuous abstinence at 12 months by more than three-fold compared with placebo.

It also boosted abstinence

by 1.7-fold compared with bupropion.

The main adverse event from varenicline was nausea, but

only at mild to moderate levels and decreasing with habituation.

The first appraisal committee meeting for the NICE technology appraisal of varenicline takes place on 18 April.

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