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Efficacy of varenicline or bupropion and its association with nicotine metabolite ratio among smokers with COPD

  • 0China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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March 18, 2024

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March 18, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Nicotine metabolic ratio (NMR) influences smoking cessation effectiveness in COPD patients. Varenicline is more effective for normal metabolizers, while bupropion is better for slow metabolizers, with fewer side effects.

Area Of Science

  • Pharmacogenomics
  • Pulmonology
  • Addiction Medicine

Background

  • Nicotine metabolic ratio (NMR) is linked to nicotine metabolism and smoking behaviors.
  • Limited research exists on NMR's impact on smoking cessation efficacy in Chronic Obstructive Pulmonary Disease (COPD) patients.

Purpose Of The Study

  • To investigate the association between NMR and smoking cessation efficacy in Chinese COPD smokers.
  • To compare the efficacy and safety of varenicline versus bupropion based on NMR in this population.

Main Methods

  • A stratified block randomized controlled trial was conducted.
  • Participants were categorized as slow (<0.31) or normal (≥0.31) metabolizers based on NMR.
  • Random assignment to varenicline or bupropion groups with follow-up up to 24 weeks.

Main Results

  • In normal metabolizers, varenicline showed a higher abstinence rate (43.1%) than bupropion (23.5%).
  • No significant difference in abstinence rates was observed between varenicline and bupropion in slow metabolizers (54.1% vs. 45.9%).
  • Slow metabolizers reported more side effects with varenicline compared to bupropion.

Conclusions

  • Varenicline is more effective than bupropion for normal metabolizers.
  • Bupropion demonstrates equivalent efficacy with fewer side effects in slow metabolizers.
  • NMR can guide personalized pharmacotherapy selection for smoking cessation in COPD patients.

Keywords:

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