Is the nicotine metabolite ratio a useful tool to improve the effectiveness, safety, and adherence to quitting smoking? Systematic review of the literature and meta-analysis.

Expert review of respiratory medicine Pub Date : 2024-11-19 DOI:10.1080/17476348.2024.2429675

José Ignacio de Granda-Orive, Adolfo Alonso-Arroyo, Daniel López-Padilla, Rafael Aleixandre-Benavent, Segismundo Solano-Reina, Juan Antonio Riesco-Miranda, Carlos Rábade-Castedo, Miguel Jiménez-Gómez, Fernando Revuelta-Salgado, Carlos A Jiménez-Ruiz

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Abstract

Introduction: We have carried out a systematic review of the literature (SRL) and a meta-analysis (MA) to answer: 1. Validity of the nicotine metabolite ratio (NMR) in improving the effectiveness of pharmacological treatments (PT) for smoking cessation (SC). 2. Validity of the NMR to improve the safety of the use of these PT? and 3. Validity of NMR in improving adherence to these PT?

Method: We carried out an SRL (six databases) and an MA for responding to the questions.

Results: PT for SC (any treatment) is more effective in smoking subjects with slow NMR compared with fast NMR. Varenicline (VR) is equally effective in fast and slow NMR (RR 1.04 [CI 95% 0.75, 1.44]). When we compared those smokers who were treated to quit smoking with VR or nicotine replacement therapy (NRT) in fast metabolizers, we found that abstinence was in favor of those who were treated with VR (RR 1.40 [CI 95% 1.02, 1.91]). Those who were treated to quit smoking with NRT presented better results in slow Metabolizers (RR 0.70 [CI 95% 0.58, 0.83]). NMR increases the safety and adherence of treatments.

Conclusions: We suggest that NMR is a good biomarker in the personalization of smoking cessation.

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尼古丁代谢物比率是提高戒烟有效性、安全性和依从性的有用工具吗？文献的系统回顾和荟萃分析。

简介我们对文献进行了系统回顾（SRL）和荟萃分析（MA），以回答以下问题：1.尼古丁代谢物比值（NMR）在提高戒烟药物治疗（PT）效果方面的有效性。2.2. NMR 在提高这些药物治疗使用安全性方面的有效性？NMR 在提高戒烟药物治疗依从性方面的有效性？我们进行了一次 SRL（六个数据库）和一次 MA 以回答问题：结果：与快速 NMR 相比，慢 NMR 对吸烟者进行 SC（任何治疗）的治疗更有效。伐伦克林（VR）对快速和慢速 NMR 同样有效（RR 1.04 [CI 95% 0.75, 1.44]）。当我们对快速代谢者中接受 VR 或尼古丁替代疗法（NRT）戒烟的吸烟者进行比较时，发现接受 VR 治疗的吸烟者更容易戒烟（RR 1.40 [CI 95% 1.02, 1.91]）。在慢代谢者中，接受 NRT 戒烟治疗的效果更好（RR 0.70 [CI 95% 0.58, 0.83]）。NMR提高了治疗的安全性和依从性：我们认为 NMR 是个性化戒烟的良好生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Expert review of respiratory medicine

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