Progesterone for Smoking Relapse Prevention Following Delivery
Progesterone for Postpartum Smokers: Feasibility, Breastfeeding and Infant Safety
Smoking is the main preventable cause of mortality in Western countries, contributing to over 430,000 deaths a year in the U.S. alone. Clinical and epidemiological studies show that women often decrease smoking in pregnancy, when progesterone levels are high. However, at least half resume pre-pregnancy smoking levels within weeks after delivery and when progesterone levels drop.
Data from preclinical and clinical studies suggest that progesterone may be effective in preventing relapse to smoking in non-postpartum women. Prior work has shown that progesterone decreases both craving for cigarettes and the subjective rewarding effects of smoking among recently abstinent female smokers. These findings led us to hypothesize that progesterone may have efficacy as a relapse prevention treatment for postpartum women.
We propose an 8-week, randomized pilot study to evaluate the safety and initial efficacy of progesterone. This will be a feasibility study that will compare progesterone to placebo for relapse prevention in 40 postpartum smokers. We will assess the feasibility and safety, including the potential effects on breastfeeding and infants exposed via breast milk, in addition to 7-day point prevalence of smoking abstinence after 8 weeks of treatment and at follow-up, 3-months after the end of the protocol.
A tanulmány áttekintése
Állapot
Körülmények
Beavatkozás / kezelés
Tanulmány típusa
Beiratkozás (Tényleges)
Fázis
- 2. fázis
Kapcsolatok és helyek
Tanulmányi helyek
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Connecticut
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New Haven, Connecticut, Egyesült Államok, 06510
- Yale School of Medicine Dpt of Psychiatry
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Részvételi kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
Egészséges önkénteseket fogad
Tanulmányozható nemek
Leírás
Inclusion Criteria:
- Need to be within 3 weeks of delivery because relapse to smoking happens early after childbirth
- Aged 18 to 42 years
- history of smoking, with smoking and other nicotine product abstinence achieved in the final two months of pregnancy and at delivery
- In good health as verified by medical history
- Using acceptable birth control methods other than hormonal contraceptives that contain progestins
- Have biologically confirmed abstinence from tobacco and other nicotine products at randomization
Exclusion Criteria:
- A history of major medical illnesses including liver diseases, suspected or known malignancy, thrombophlebitis, liver failure, or other medical conditions that the physician investigator deems will make study participation unsafe for the subject
- Current or past history bipolar disorder or schizophrenia or current diagnosis of major depression, panic disorder or post-traumatic stress disorder
- Dependence on and/or abuse of alcohol or other drugs of abuse in the month prior to randomization into the trial
- the presence of suicidal or homicidal ideation, or significant impairment of social or occupational functioning, either at study baseline during the evaluation process, or during participation in the trial
- inability to speak Spanish or English (our group is bilingual)
- plans to move out of the area within 8 months after study screening since this will make follow-up difficult
- Inability to understand study procedures or provide informed consent
- Currently undergoing treatment with another pharmacological agent for smoking cessation
- pending legal case that may result in incarceration since this would force abstinence and impede follow-up;
- Pending case with child protective services that might lead removal of infant from mother's custody, as this would impede breastfeeding and infant follow-up
- Unwilling to accept randomization
- Subsequent pregnancy since that would be another source of progesterone
- An acute general medical condition that would require imminent re-hospitalization since this would enforce abstinence (women may be randomized if they are discharged and still within the recruitment window)
- Allergy to progesterone or peanuts (vehicle for micronized progesterone)
- Currently undergoing treatment with ketoconazole or any other known strong CYP3A4 inhibitors
Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Kezelés
- Kiosztás: Véletlenszerűsített
- Beavatkozó modell: Párhuzamos hozzárendelés
- Maszkolás: Hármas
Fegyverek és beavatkozások
Résztvevő csoport / kar |
Beavatkozás / kezelés |
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Placebo Comparator: placebo
In this group women will receive a placebo pill which will appear similar to progesterone and will be inert.
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Kísérleti: Progesterone
In this group women will receive oral micronized progesterone twice a day.
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oral micronized progesterone
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Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
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Feasibility of Progesterone as a Relapse Prevention Intervention for Postpartum Women With Pre-conception Smoking: Adherence to Treatment
Időkeret: 8 weeks
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Feasibility will be shown by high adherence to treatment condition assessed by doses of study medication taken
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8 weeks
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Feasibility of Progesterone as a Relapse Prevention Intervention for Postpartum Women With Pre-conception Smoking: Retention
Időkeret: From randomization to 3-month follow-up: up to 5 months
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Feasibility in retention will be shown by at least 70% of women randomized to the progesterone group reamaining in the study at the 3-month follow-up
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From randomization to 3-month follow-up: up to 5 months
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Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
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7-day Point Prevalence of Abstinence at End of Treatment (Week 8)
Időkeret: Week 8 of the trial period
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Abstinence was defined as self-report of no smoking in the past 7 days confirmed by a negative urine cotinine test (urine cotinine <100 ng/ml).
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Week 8 of the trial period
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Együttműködők és nyomozók
Szponzor
Együttműködők
Nyomozók
- Kutatásvezető: Ariadna Forray, MD, Yale School of Medicine
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete
Elsődleges befejezés (Tényleges)
A tanulmány befejezése (Tényleges)
Tanulmányi regisztráció dátumai
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Becslés)
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
Kulcsszavak
További vonatkozó MeSH feltételek
Egyéb vizsgálati azonosító számok
- 1305012130
- R21DA035924 (Az Egyesült Államok NIH támogatása/szerződése)
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