The trial was conducted at four academic medical centers.
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Participants were randomized to receive one of the following for 11 weeks: the nicotine patch plus a placebo pill varenicline plus placebo patch or both placebo pill and patch.
Researchers hope the findings will spur others to create a test that could be used by doctors to optimize the cessation rates for all people without unnecessarily exposing them to a drug which doesn’t work as well, or has avoidable side effects.Īs reported online in the Lancet Respiratory Medicine, the clinical trial categorized 1,246 smokers who were seeking treatment as either slow metabolizers (662) or normal metabolizers (584). Unfortunately, there are no commercial tests for this biomarker on the market-so, right now, smokers and their physicians currently have no way of knowing which approach is likely to work best. “Matching a treatment choice based on the rate at which smokers metabolize nicotine could be a viable strategy to help guide choices for smokers and ultimately improve quit rates.” “This is a much-needed, genetically informed biomarker that could be translated into clinical practice,” says co-lead author Caryn Lerman, professor of psychiatry at University of Pennsylvania.
Varenicline is just as effective as the patch for “slow” metabolizers, but can lead to more side effects than the patch. Slow metabolizers, on the other hand, could benefit the most from the nicotine patch.
Normal metabolizers of nicotine are significantly more likely to remain abstinent from smoking after treatment with varenicline compared to the nicotine patch, at the end of treatment, and six months later.
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