2021 randomized clinical trials of varenicline versus cytosine produce different results.
Smoking Cessation: 2021 randomized clinical trials of varenicline versus cytosine produce different results. The most recent study In Australia found varenicline superior, but cytisine was more effective in a March 2021 study in New Zealand (See below).
Courtney RJ, McRobbie H, Tutka P, et al. Effect of Cytisine vs Varenicline on Smoking Cessation: A Randomized Clinical Trial. JAMA. 2021;326(1):56-64.
Among 1452 participants who were randomized (mean [SD] age, 42.9 [12.7] years; 742 [51.1%] women), 1108 (76.3%) completed the trial. Verified 6-month continuous abstinence rates were 11.7% for the cytisine group and 13.3% for the varenicline group (risk difference, −1.62% [1-sided 97.5% CI, −5.02% to ∞]; P = .03 for noninferiority).
https://jamanetwork.com/journals/jama/fullarticle/2781643
A March 2021 study in New Zealand found cytisine at least as effective as varenicline at supporting smoking abstinence in a New Zealand indigenous Māori population.
Walker N, et al. Cytisine versus varenicline for smoking cessation in New Zealand indigenous Māori: a randomized controlled trial. Addiction. 24 March 2021. https://onlinelibrary.wiley.com/doi/10.1111/add.15489
One medical news reporter noted, “Extended dosing would be worth testing in a future study; the contrary results in the Maori trial might suggest that populations more accepting of “natural” products (cytisine is a plant alkaloid), would respond better to cytisine than to varenicline.
Some of these questions could be answered in an ongoing, placebo-controlled, phase III trial with a proprietary cytisine formulation called cytisinicline, in which the agent is given for up to 12 weeks.” (Gever J. in Medpage Today) https://www.medpagetoday.com/primarycare/smoking/93429
Stephen Hamann
