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Monday, January 19, 2015

Success Of Smoking Cessation Treatments May Depend On Nicotine Metabolism Rates

Anyone contemplating the services of North Carolina treatment programs offered to young adults may wish to take time out to read some recent research. A new study took the form of a randomized clinical trial of smokers attempting to quit, and found that the speed with which a given person's body metabolizes nicotine may impact on the effectiveness of certain smoking cessation therapies.

Success rates of the nicotine patch were compared by the study with those of the prescription medication varenicline. Participants with "normal" nicotine metabolic rates found that varenicline was much more effective at assisting them to refrain from smoking, both at the end of treatment and six months after treatment.

"Slow" metabolizers, meanwhile, didn't experience as many side effects when they used the nicotine patch as when varenicline was used, but there was no difference in success rates between the two. Such information is sure to interest prescribers looking to make the most appropriate smoking cessation treatment recommendations on the basis of the individual profiles of their patients.

The research benefited from funding from the National Institute on Drug Abuse (NIDA) and the National Cancer Institute (NCI), National Human Genome Research Institute (NHGRI) and National Institute of General Medical Sciences (NIGMS) at the National Institutes of Health (NIH). The article, Use of the nicotine metabolite ratio as a genetically informed biomarker of response to nicotine patch or varenicline for smoking cessation: a randomised, double-blind placebo-controlled trial was published in The Lancet Respiratory Medicine. The article summary commented that "Substantial variability exists in therapeutic response and adverse effects with pharmacotherapies for tobacco dependence. We tested whether a genetically informed biomarker of nicotine clearance, the nicotine metabolite ratio (NMR; 3′-hydroxycotinine:cotinine), predicts response to nicotine patch or varenicline for smoking cessation."

The clinical trial took place across four sites from November 16, 2010, to September 12, 2014, and involved 1246 participants - 662 of which were slow metabolizers of nicotine, with 584 being fast metabolizers of nicotine - who were randomly assigned to three interventions. 420 were given varenicline, 418 were assigned the nicotine patch and 408 received the placebo.

The subsequent findings led the researchers to conclude that "Treating normal metabolizers with varenicline and slow metabolizers with nicotine patch could optimize quit rates while minimizing side-effects" - an interpretation that may help to improve future North Carolina treatment for smoking cessation.

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