ヴァレニクリン または ニコチン 置換 薬 の 最初 の 治療 が 失敗 し た 後 の 禁煙: ランダム 化 さ れ た 臨床 試験
Paul M Cinciripini1, Charles E Green2, Sanjay Shete1
1Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston.
JAMA
|May 2, 2024
まとめ
最初 禁煙しない喫煙者の場合,バレニクリンの投与量を増やすことで禁煙が促進されます. 併用ニコチン置換療法 (CNRT) の後にバレニクリンに切り替えるか,または投与量を増加させるのも,禁煙に役立つ.
科学分野:
- 依存症 医学
- 臨床薬理学
- 公衆衛生
背景:
- 喫煙 者 の 大半 は,最初 の 試み で 禁煙 する こと に 失敗 する.
- 禁煙をしない人に対して 効果的な二次禁煙戦略が必要である.
研究 の 目的:
- ヴァレニクリンまたは併用ニコチン置換療法 (CNRT) の初期治療で禁煙が達成できない喫煙者に対する最適な治療戦略を決定する.
主な方法:
- 490人のボランティアを対象とした 連続的な多重割り当てのランダム化試験です
- 参加者はバレニクリンまたはCNRTを6週間投与され,禁酒していない人はさらに6週間継続,切り替え,または投与量を増加させるように再ランダム化されました.
- 生物化学的に確認された7日ポイントの禁欲は12週間の主な結果でした.
主要な成果:
- バレニクリンを断った患者では,投与量を増加させた結果,断食率は20%で,初期投与量を継続した患者より大幅に高かった (3%).
- CNRTを断った患者では,バレニクリンに切り替えると (14%の断食),またはCNRTの投与量を増加させると (14%の断食) は,最初のCNRTを継続した患者と比較して結果が改善されました (8%).
- ヴァレニクリンとCNRTの両方の投与量の増加は,6ヶ月間の継続的な禁欲の効果を示しました.
結論:
- バレニクリンで治療された喫煙者の場合,投与量を増加させることが有効な救済策です.
- CNRTで治療された喫煙者にとって,最初の禁欲を達成できない場合は,バレニクリンの投与に切り替えるか,またはCNRTの投与量を増加させるのが実行可能な救済策です.
- これらの発見は,個々の患者のニーズに合わせた 禁煙治療の価値ある洞察を提供します.
関連する概念動画
Drugs Acting on Autonomic Ganglia: Stimulants
1.3K
Ganglionic stimulants activate NM nicotinic receptors in autonomic ganglia, falling into two categories: nicotine mimetics [e.g., lobeline, dimethylpiperazine, tetramethylammonium] and muscarinic receptor agonists [e.g., muscarine, methacholine]. The first category's action is rapid and blocked by nicotinic receptor antagonists, while the second category's action is delayed and blocked by atropine-like agents. Nicotine, an alkaloid, affects the heart rate by stimulating...
1.3K
Stimulants
190
Stimulants are substances that enhance neural activity and elevate dopamine levels in the brain, leading to their highly addictive nature. These drugs include cocaine, amphetamines, MDMA, caffeine, and nicotine, each with distinct mechanisms of action and varied health implications.
Cocaine can be administered via snorting, injection, or smoking. It primarily functions by blocking the reuptake of dopamine, resulting in a euphoric high characterized by an intense sensation of happiness and...
Cocaine can be administered via snorting, injection, or smoking. It primarily functions by blocking the reuptake of dopamine, resulting in a euphoric high characterized by an intense sensation of happiness and...
190
Drug Dependence
1.0K
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
1.0K
Chronic Obstructive Pulmonary Disease-V: Management
2.5K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.5K
CNS Depressants: Alcohol and Nicotine
205
Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
205
Clinical Trials: Overview
2.9K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
2.9K


