Pharmacotherapy for smoking cessation: pharmacological principles and clinical practice

Aubin, Henri‐Jean; Luquiens, Amandine; Berlin, Ivan

doi:10.1111/bcp.12116

Cited by 106 publications

(77 citation statements)

References 157 publications

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“…However, secondary analyses of patients who had relapsed in both groups revealed the same number of drinking days, but significantly lower alcohol consumption with galantamine [76]. Varenicline, an alpha4beta2 nicotinic receptor partial agonist, is labeled for smoking cessation in most countries [77]. Preclinical animal studies and human trials, and also observational studies have shown that varenicline can reduce alcohol use in heavy-drinking smokers [78,79].…”

Section: Pharmacotherapy Trials Supporting the Reduction Conceptmentioning

confidence: 99%

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

2017

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Abstinence from alcohol has been the prevailing treatment goal for individuals with alcohol dependence (AD) within the context of specialty alcohol treatment. Yet, alcohol use has been conceptualized as existing on a continuum. Importantly, most people who meet criteria for AD and could benefit from treatment never receive treatment. About half of these individuals do not seek treatment because they report a desire to continue drinking. To increase acceptability of treatment, reductions in alcohol consumption have been examined as alternative outcomes in treatment trials for AD. The current study reviews data which indicate that long-term reduction in alcohol consumption among patients with AD is possible. Controlled studies have tested reduced alcohol consumption and show sustained improvements in drinking reductions for many patients following behavioral treatments and pharmacotherapy. Evidence-based treatment guidelines and medicines development guidance authorities have taken note of these developments and accept “intermediate harm reduction” (European Medicines Agency) or “low-risk drinking limits” (US Federal Drug Administration) as optional trial endpoints. In conclusion, while abstinence remains the safest treatment goal for individuals with AD, evidence supports that reduced drinking approaches may be an important extension in the treatment of AD.

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Section: Pharmacotherapy Trials Supporting the Reduction Conceptmentioning

confidence: 99%

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

2017

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“…A combination of BUP and naltrexone was recently approved by the U.S. Food and Drug Administration for weight management (Yanovski and Yanovski, 2015), and BUP has been tested for multiple other indications (Dwoskin et al, 2006;Dhillon et al, 2008;Aubin et al, 2014). However, BUP use is associated with large interpatient variability in clinical response (Hurt et al, 1997;Jorenby et al, 1999;Dale et al, 2001;Thase et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Chiral Plasma Pharmacokinetics and Urinary Excretion of Bupropion and Metabolites in Healthy Volunteers

Masters

Gufford

et al. 2016

Journal of Pharmacology and Experimental Therapeutics

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Bupropion, widely used as an antidepressant and smoking cessation aid, undergoes complex metabolism to yield numerous metabolites with unique disposition, effect, and drug-drug interactions (DDIs) in humans. The stereoselective plasma and urinary pharmacokinetics of bupropion and its metabolites were evaluated to understand their potential contributions to bupropion effects. Healthy human volunteers (n 5 15) were administered a single oral dose of racemic bupropion (100 mg), which was followed by collection of plasma and urine samples and determination of bupropion and metabolite concentrations using novel liquid chromatography-tandem mass spectrometry assays. Time-dependent, elimination rate-limited, stereoselective pharmacokinetics were observed for all bupropion metabolites. Area under the plasma concentration-time curve from zero to infinity ratios were on average approximately 65, 6, 6, and 4 and C max ratios were approximately 35, 6, 3, and 0.5 for (2R,3R)-/(2S,3S)-hydroxybupropion, R-/S-bupropion, (1S,2R)-/(1R,2S)-erythrohydrobupropion, and (1R,2R)-/(1S,2S)-threohydrobupropion, respectively. The R-/S-bupropion and (1R,2R)-/(1S,2S)-threohydrobupropion ratios are likely indicative of higher presystemic metabolism of S-versus R-bupropion by carbonyl reductases. Interestingly, the apparent renal clearance of (2S,3S)-hydroxybupropion was almost 10-fold higher than that of (2R,3R)-hydroxybupropion. The prediction of steadystate pharmacokinetics demonstrated differential stereospecific accumulation [partial area under the plasma concentration-time curve after the final simulated bupropion dose (300-312 hours) from 185 to 37,447 nM×h] and elimination [terminal half-life of approximately 7-46 hours] of bupropion metabolites, which may explain observed stereoselective differences in bupropion effect and DDI risk with CYP2D6 at steady state. Further elucidation of bupropion and metabolite disposition suggests that bupropion is not a reliable in vivo marker of CYP2B6 activity. In summary, to our knowledge, this is the first comprehensive report to provide novel insight into mechanisms underlying bupropion disposition by detailing the stereoselective pharmacokinetics of individual bupropion metabolites, which will enhance clinical understanding of bupropion's effects and DDIs with CYP2D6.

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“…23 In a compilation in the Cochrane Library, varenicline was found to be most effective in terms of its effectiveness in quitting smoking, with NRT and bupropion having similar performance, yet, varenicline revealed significantly better results compared to bupropion. 24 In a meta-analysis where randomized controlled studies were re-evaluated, varenicline proved to be successful in both the notreatment group and the bupropion group. 25 According to the results of this research, participants remaining longer in their treatment regardless of the modality stay free of smoking for longer periods.…”

Section: Discussionmentioning

confidence: 99%

Follow-Up Study Results of Patients of a Cigarette Cessation Clinic and Factors Affecting These Results

Teker¹,

Lüleci²

2016

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : One third of approximately 1.5 billion smokers live in 10 countries, which involves Turkey. Smoking cessation clinics are increasing day by day. However, long term smoking cessation rates are unsatisfactory. The aim of this research is to calculate success rates for the patients who admitted to smoking cessation outpatient clinic in light of the data that will be obtained from follow-ups, to determine their tobacco-use behaviours, the complicating and facilitating factors that are encountered during smoking cessation process and calculate effectiveness of different therapy modalities for tobacco cessation, thereby to contribute to tobacco control strategies, and to increase the success of tobacco cessation interventions. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 114 patients who admitted to smoking cessation clinic were followed up for 6 months. Patients' status of restarting smoking during follow-up was calculated based on even if smoking just a draw (slip) criterion. R Re es su ul lt ts s: : The periods without smoking for participants whose spouses do not smoke, who used treatment for 28 days and more and whose type of treatment is varenicline were longer. In multivariate analyses, non-smoker spouse, long treatment period and varenicline use as treatment option were found to be factors positively affecting the success rate. C Co on nc cl lu us si io on n: : The mean period without smoking for the participants in the first month found to be 12.8 days, have revealed that close follow-up of the patient in this early period is very critical in smoking cessation process. In addition to provision of proper treatment to patients, ensuring that the patient uses this treatment for a sufficient amount of time is also important in tobacco cessation process. Concomitant treatment of tobacco using partners or encouraging the non-smoker partner to actively participate in treatment process may increase the success rate of tobacco cessation.K Ke ey y W Wo or rd ds s: : Smoking; smoking cessation; varenicline; bupropion Ö ÖZ ZE ET T A Am ma aç ç: : Dünya genelinde sigara içen yaklaşık 1,5 milyar insanın üçte biri 10 ülkede yaşamaktadır. Türkiye de bu on ülke arasında yer almaktadır. Bu amaçla hizmet veren sigara bırakma polikliniği sayıları ve bu polikliniklere yapılan başvuru sayıları gün geçtikçe artmaktadır. Ancak uzun dönemde sigara bırakma başarı oranları istenildiği gibi değildir. Bu araştırmanın amacı sigara bırakma polikliniğine yardım için başvuran hastaların sigara kullanma özelliklerini belirlemek ve izlemlerinden elde edilecek bilgiler ışığında başarı oranlarını hesaplamak, sigara bırakma sürecinde karşılaştıkları zorlaştırıcı ve kolaylaştırıcı faktörleri belirlemek, farklı tedavi yöntemlerinin etkinliğini hesaplamak bu yolla tütün kontrolü stratejilerine katkıda bulunmak ve tütün bırakma girişimlerinin başarısını artırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : İle-riye dönük kohort türündeki bu araştırmada sigara bırakma...

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Pharmacotherapy for smoking cessation: pharmacological principles and clinical practice

Cited by 106 publications

References 157 publications

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

Chiral Plasma Pharmacokinetics and Urinary Excretion of Bupropion and Metabolites in Healthy Volunteers

Follow-Up Study Results of Patients of a Cigarette Cessation Clinic and Factors Affecting These Results

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