Association of nicotine metabolism and sex with relapse following varenicline and nicotine replacement therapy.

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State: Public
Version: author
Serval ID
serval:BIB_C398035F5631
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Association of nicotine metabolism and sex with relapse following varenicline and nicotine replacement therapy.
Journal
Experimental and clinical psychopharmacology
Author(s)
Glatard A., Dobrinas M., Gholamrezaee M., Lubomirov R., Cornuz J., Csajka C., Eap C.B.
ISSN
1936-2293 (Electronic)
ISSN-L
1064-1297
Publication state
Published
Issued date
10/2017
Peer-reviewed
Oui
Volume
25
Number
5
Pages
353-362
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Nicotine is metabolized into cotinine and then into trans-3'-hydroxycotinine, mainly by cytochrome P450 2A6. Recent studies reported better effectiveness of varenicline in women and in nicotine normal metabolizers phenotypically determined by nicotine-metabolite ratio. Our objective was to study the influence of nicotine-metabolite ratio, CYP2A6 genotype and sex on the response to nicotine replacement therapy and varenicline. Data were extracted from a longitudinal study which included smokers participating in a smoking cessation program. Response to treatment was defined by the absence of relapse when a set threshold of reduction in cigarettes per day relative to the week before the study was no more reached. The analysis considered total and partial reduction defined by a diminution of 100% and of 90% in cigarettes per day, respectively. The hazard ratio of relapsing was estimated in multivariate Cox regression models including the sex and the nicotine metabolism determined by the phenotype or by CYP2A6 genotyping (rs1801272 and rs28399433). In the normal metabolizers determined by phenotyping and in women, the hazard ratio for relapsing was significantly lower with varenicline for a partial decrease (HR = 0.33, 95% CI [0.12, 0.89] and HR = 0.20, 95% CI [0.04, 0.91], respectively) and nonsignificantly lower for a total cessation (HR = 0.45, 95% CI [0.20, 1.0] and HR = 0.38, 95% CI [0.14, 1.0]). When compared with the normal metabolizers determined by phenotyping, the hazard ratio for a partial decrease was similar in the normal metabolizers determined by genotyping (HR = 0.42, 95% CI [0.18, 0.94]) while it was significantly lower with varenicline for a total cessation (HR = 0.50, 95% CI [0.26, 0.98]). Women and normal nicotine metabolizers may benefit more from varenicline over nicotine replacement therapy. (PsycINFO Database Record
Keywords
Adult, Cotinine/analogs & derivatives, Cotinine/metabolism, Cytochrome P-450 CYP2A6/metabolism, Female, Genotype, Humans, Longitudinal Studies, Male, Middle Aged, Nicotine/metabolism, Recurrence, Smoking/metabolism, Smoking Cessation, Tobacco Products, Varenicline/administration & dosage
Pubmed
Web of science
Open Access
Yes
Create date
30/10/2017 11:54
Last modification date
20/08/2019 16:38
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