Study into smoking cessation drug finds no increased risk of serious side effects

Smoking not only increases the risk of the development of malignant tumors (MT), but affects the disease prognosis, mortality and survivability of cancer patients. The link between the smoking of cancer patients and increased risk of death by all diseases and oncological causes has been established. Mortality increases with the growth of the smoking intensity, i.e. the number of cigarettes, smoked per day. Smoking is associated with the worst general and oncological survivability. The statistically trend-line between the smoking intensity and survivability was observed: each additional unit of cigarette consumption (pack/year) leads to the Overall Survival Reduction by 1% (p = 0.002). The link between smoking and the risk of developing second primary tumors has been confirmed. Smoking increases the likelihood of side effects of the antitumor therapy both drug therapy and radiation therapy and reduces the treatment efficacy. The smoking cessation leads to a significant improvement in the prognosis of a cancer patient. Scientific data on the negative effect of smoking on the prognosis of cancer patients have a major clinical importance. The treatment program for cancer patients should include science-based methods for the smoking cessation. The latter is fundamentally important, taking into account that the smoking frequency among cancer patients is much higher than in the population.

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The Effects of Smoking Cessation on Diabetes Mellitus Patients

Current Diabetes Reviews ◽

10.2174/1573399815666190729111041 ◽

2020 ◽

Vol 16 (2) ◽

pp. 137-142

Author(s):

Ali Alshahrani

Keyword(s):

Smoking Cessation ◽

The Other ◽

Data Sources ◽

Controlled Trials ◽

Effective Management ◽

Tailored Intervention ◽

Randomized Controlled ◽

Increased Risk ◽

Diabetes Progression

Background: Smoking is an established predictor of type 2 diabetes. However, the link between smoking cessation and diabetes progression remains a subject of scholarly investigation. Objective: The objective of this systematic review is to establish the link between smoking cessation and diabetes. Data Sources: The study utilized conference abstracts and peer-reviewed journals that reported randomized controlled trials smoking cessation interventions for diabetes patients. Results: Results from the review were inconclusive on the link between smoking cessation and diabetes. On one hand, several researchers have confirmed a positive correlation between smoking cessation and decreased risk of diabetes. On the other hand, some researchers have demonstrated that immediate withdrawal of nicotine resulted in increased risk of diabetes; however, this risk reduces with time. Conclusion: The result of this review did not estblish a clear relationship between smoking cessation and diabates. Limitations: Compared to other studies examining the implication of smoking on chronic diseases, this study identified a very small number of trials evaluating the effect of smoking cessation on diabetes. The small number of studies implies that the results may not be suitable for generalization. Implication: Results from the review can help in the development of a tailored intervention for effective management of diabetes in smoking patients.

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AB1326-HPR TOBACCO ADDICTION IN PEOPLE WITH RHEUMATOID ARTHRITIS – FROM THE PERSPECTIVE OF PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.965 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1952.2-1952

Author(s):

B. A. Esbensen ◽

I. K. Roelsgaard ◽

S. K. Larsen ◽

T. Thomsen

Keyword(s):

Rheumatoid Arthritis ◽

Smoking Cessation ◽

Tobacco Smoking ◽

Physical Dependence ◽

The Body ◽

Controlled Study ◽

Structured Interviews ◽

Background Population ◽

Increased Risk ◽

Tobacco Addiction

Background:Smoking is one of the most significant modifiable exosomes risk factors for rheumatoid arthritis (RA) (1). Studies suggest that 25-30% of people with RA in Denmark smoke (2). This is almost twice as many as in the background population in Denmark. People with RA have a significant increased risk of severe comorbidity including cardiovascular disease. In addition, there are indications that smokers with RA have a poorer effect of the medical inflammatory treatment compared to non-smokers, and consequently more difficult to achieve remission of the disease activity (3). Tobacco addiction is complex and can be a challenge in smoking cessation. In addition to physiological dependence, habits and social and environmental factors may influence addiction. Tobacco smoking is associated with an addiction to nicotine and it is unexplored how this addiction appears in people with RA.Objectives:The aim of this study was to examine from the patient’s perspective how tobacco addiction appears in people with rheumatoid arthritis.Methods:We conducted a qualitative study based on a hermeneutics approach. People with RA who previously had participated in a randomized controlled study (4) about smoking cessation conducted at the Center for Rheumatology and Spine Diseases at Rigshospitalet, Denmark were recruited for semi-structured interviews.Results:In total, 12 people with RA (50% female) were included in the study. The median age was 62 years and median RA disease duration was 12 years. The degree of physical dependence measured by Fagerströms Test for Nicotine dependence (FTND) was on average: 4.9 (score: 0-10, 0=nonphysical dependence).Three categories of how tobacco addiction appeared emerged during the analysis: 1)It develops into ingrown habitsreferring to the fact that smoking already in adolescence contributes to the development of specific physical, mental and social smoking behavior. Not all individuals considered themselves addicted to nicotine as they did not necessarily connect the nicotine to the ingrown habits. 2)The body craves for nicotinereferring to nicotine proved calming, while a lacking or insufficient dose caused withdrawal symptoms. Furthermore, smoking became a habit where a craving for smoking occurred in certain situations. 3)Ambivalence – for and againstreferring to the physical dependence and smoking habits making a smoking cessation difficult. Dependency to nicotine and challenges to quit smoking led to a feeling of ambivalence and a lack of control.Conclusion:Tobacco addiction appeared as a physical dependence and a habit, which, during a smoking cessation, led to ambivalent feelings. Therefore, based on this study, there is still a need for health professionals to talk to patients about smoking. But also, a need to articulate the complexity of addiction in order to support for smoking cessations. Information should be strengthened in the clinical practice in relation to nicotine’s implication in tobacco addiction as well as the consequences of tobacco smoking for individuals with RA.References:[1]Scott DL, Wolfe F, Huizinga TW. Lancet. 2010 ###[2]Loppenthin K, Esbensen BA, Jennum P, Ostergaard M, Tolver A, Thomsen T, et al. Clin Rheumatol. 2015. ###[3]Roelsgaard IK, Ikdahl E, Rollefstad S, Wibetoe G, Esbensen BA, Kitas GD, et al. Rheumatology (Oxford). 2019. ###[4]Roelsgaard IK, Thomsen T, Ostergaard M, Christensen R, Hetland ML, Jacobsen S, et al. Trials. 2017;18(1):570.###Disclosure of Interests:None declared

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Natural Bioactive Compounds Useful in Clinical Management of Metabolic Syndrome

Nutrients ◽

10.3390/nu13020630 ◽

2021 ◽

Vol 13 (2) ◽

pp. 630 ◽

Cited By ~ 2

Author(s):

Annalisa Noce ◽

Manuela Di Lauro ◽

Francesca Di Daniele ◽

Anna Pietroboni Zaitseva ◽

Giulia Marrone ◽

...

Keyword(s):

Oxidative Stress ◽

Metabolic Syndrome ◽

Side Effects ◽

Bioactive Compounds ◽

Clinical Management ◽

Endothelial Damage ◽

Low Grade ◽

Clinic Management ◽

Pharmaceutical Therapy ◽

Increased Risk

Metabolic syndrome (MetS) is a clinical manifestation characterized by a plethora of comorbidities, including hyperglycemia, abdominal obesity, arterial hypertension, and dyslipidemia. All MetS comorbidities participate to induce a low-grade inflammation state and oxidative stress, typical of this syndrome. MetS is related to an increased risk of cardiovascular diseases and early death, with an important impact on health-care costs. For its clinic management a poly-pharmaceutical therapy is often required, but this can cause side effects and reduce the patient’s compliance. For this reason, finding a valid and alternative therapeutic strategy, natural and free of side effects, could represent a useful tool in the fight the MetS. In this context, the use of functional foods, and the assumption of natural bioactive compounds (NBCs), could exert beneficial effects on body weight, blood pressure and glucose metabolism control, on endothelial damage, on the improvement of lipid profile, on the inflammatory state, and on oxidative stress. This review focuses on the possible beneficial role of NBCs in the prevention and in the clinical management of MetS and its comorbidities.

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Conclusion

The Benzodiazepines Crisis ◽

10.1093/med/9780197517277.003.0014 ◽

2020 ◽

pp. 237-238

Author(s):

John F. Peppin ◽

Joseph V. Pergolizzi ◽

Robert B. Raffa ◽

Steven L. Wright

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Side Effects ◽

Mechanism Of Action ◽

Term Treatment ◽

Risk Of Death ◽

Increased Risk ◽

Treatment Plans ◽

The Central Nervous System ◽

System Data

The authors summarize the harmful and understudied aspects of the overuse of benzodiazepines. Increased and longer-term use of benzodiazepines has been observed to lead to side effects such as sedation, cognitive issues, abuse, and dependence, as well as many other unanticipated side effects that do not fit their known mechanism of action in the central nervous system. Data also shows a correlation between concomitant use of benzodiazepines and opioids and increased risk of death from overdose. The authors advocate for stricter guidelines for prescribing benzodiazepines, as well as close clinical monitor and shorter-term treatment plans.

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Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17062034 ◽

2020 ◽

Vol 17 (6) ◽

pp. 2034 ◽

Cited By ~ 2

Author(s):

Gillian S. Gould ◽

Alys Havard ◽

Ling Li Lim ◽

Ratika Kumar ◽

Keyword(s):

Smoking Cessation ◽

Health Outcomes ◽

Pregnant Women ◽

Replacement Therapy ◽

Nicotine Replacement Therapy ◽

Systematic Reviews ◽

Nicotine Replacement ◽

Increased Risk ◽

Pertinent Data ◽

In Pregnancy

The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother’s and child’s health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.

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Impact of COVID-19 on the Hong Kong Youth Quitline Service and Quitting Behaviors of Its Users

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228397 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8397

Author(s):

Laurie Long Kwan Ho ◽

William Ho Cheung Li ◽

Ankie Tan Cheung ◽

Wei Xia ◽

Man Ping Wang ◽

...

Keyword(s):

Smoking Cessation ◽

Risk Factor ◽

Hong Kong ◽

Tobacco Use ◽

Telephone Survey ◽

Quit Smoking ◽

Quit Rate ◽

Increased Risk ◽

Young Smokers ◽

The Impact

Tobacco use is a possible risk factor for contracting and spreading COVID-19. We aimed to describe the impact of the COVID-19 pandemic on the Youth Quitline service and quitting behaviors of its users in Hong Kong. We conducted a telephone survey involving 201 participants of the Youth Quitline service, and retrospectively analyzed the operation and use of Quitline since the COVID-19 outbreak in Hong Kong. The number of incoming calls to the Youth Quitline and the participants′ quit rate has increased since the COVID-19 outbreak in Hong Kong. Many participants (68%) did not realize that tobacco use potentially increased their risk for developing and spreading COVID-19; however, 43% agreed that the pandemic motivated their intention to quit, and 83% changed their smoking habits during the pandemic. These changes were mainly due to wearing masks (30%), closure of bars/pubs (25%), suspension of classes (14%), and being unable to socialize with friends (24%). Overall, 58% reduced their tobacco use; of these participants, 66% reported a ≥50% reduction in daily cigarette consumption. The participants reduced their smoking during the COVID-19 pandemic despite lacking knowledge about the potentially increased risk for contracting COVID-19 from continued smoking. The pandemic could create new opportunities to motivate young smokers to quit smoking, especially those seeking support for smoking cessation, and may further contribute to reducing the risks posed by COVID-19.

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Natural Compounds for the Management of Parkinson’s Disease and Attention-Deficit/Hyperactivity Disorder

BioMed Research International ◽

10.1155/2018/4067597 ◽

2018 ◽

Vol 2018 ◽

pp. 1-12 ◽

Cited By ~ 12

Author(s):

Juan Carlos Corona

Keyword(s):

Oxidative Stress ◽

Parkinson’S Disease ◽

Attention Deficit Hyperactivity Disorder ◽

Parkinson's Disease ◽

Side Effects ◽

Attention Deficit ◽

Neurological Disorders ◽

Natural Compounds ◽

Hyperactivity Disorder ◽

Increased Risk

Parkinson’s disease (PD) is the second most common neurodegenerative disorder with an unknown aetiology. The pathogenic mechanisms include oxidative stress, mitochondrial dysfunction, protein dysfunction, inflammation, autophagy, apoptosis, and abnormal deposition of α-synuclein. Currently, the existing pharmacological treatments for PD cannot improve fundamentally the degenerative process of dopaminergic neurons and have numerous side effects. On the other hand, attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood and is characterised by hyperactivity, impulsivity, and inattention. The aetiology of ADHD remains unknown, although it has been suggested that its pathophysiology involves abnormalities in several brain regions, disturbances of the catecholaminergic pathway, and oxidative stress. Psychostimulants and nonpsychostimulants are the drugs prescribed for the treatment of ADHD; however, they have been associated with increased risk of substance use and have several side effects. Today, there are very few tools available to prevent or to counteract the progression of such neurological disorders. Thus, therapeutic approaches with high efficiency and fewer side effects are needed. This review presents a brief overview of the two neurological disorders and their current treatments, followed by a discussion of the natural compounds which have been studied as therapeutic agents and the mechanisms underlying the beneficial effects, in particular, the decrease in oxidative stress.

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Domperidone Versus Metoclopramide: Self-Reported Side Effects in a Large Sample of Breastfeeding Mothers Who Used These Medications to Increase Milk Production

Clinical Lactation ◽

10.1891/2158-0782.9.1.10 ◽

2018 ◽

Vol 9 (1) ◽

pp. 10-17 ◽

Cited By ~ 8

Author(s):

Thomas W. Hale ◽

Kathleen Kendall-Tackett ◽

Zhen Cong

Keyword(s):

Side Effects ◽

Milk Production ◽

Cardiac Arrhythmias ◽

Online Survey ◽

Relative Safety ◽

Increased Risk ◽

Rare Side Effect ◽

Increase Milk Production ◽

The Central Nervous System ◽

Cns Side Effects

Introduction: Metoclopramide and domperidone are medications that block dopamine receptors on the lactotrophs, allowing prolactin levels to rise. Both medications are prescribed to boost milk production in mothers with low milk production due to hypoprolactinemia. The Food and Drug Administration has not approved the use of domperidone in the U.S. because of concerns about increased risk of cardiac arrhythmias. Metoclopramide is often recommended instead. Unfortunately, metoclopramide affects the central nervous system (CNS) and increases the risk of both depression and tardive dyskinesia (TD).Method: The present study is an online survey of self-reported side effects of 1,990 mothers, representing 25 countries, who took metoclopramide, domperidone, or both medications to enhance milk production. Data were collected in 2010.Results: The results indicated that side effects, in general, affected only a small percentage of women who took either medication. Women were 3.6 times more likely to report no side effects when taking domperidone vs. metoclopramide. There were no significant differences in cardiac arrhythmias for women who took metoclopramide versus domperidone. Racing heart was more common with metoclopramide. Less than 1% reported these symptoms in both groups. However, CNS effects were significantly more common in women who took metoclopramide. Risk of depression increased by seven times, and symptoms of TD (tremors, involuntary grimaces, and jerking) increased by 4 to 19 times when women took metoclopramide.Discussion: The results of the present study are preliminary, but suggest that cardiac arrhythmias are a rare side effect with both medications. The CNS side effects with metoclopramide are more concerning, particularly depression and TD. It is hoped that the recommendations regarding the relative safety of these medications will be re-examined in light of these findings.

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Decreased Mortality in Coronavirus Disease 2019 Patients Treated With Tocilizumab: A Rapid Systematic Review and Meta-analysis of Observational Studies

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1445 ◽

2020 ◽

Cited By ~ 12

Author(s):

Jishnu Malgie ◽

Jan W Schoones ◽

Bart G Pijls

Keyword(s):

Side Effects ◽

Meta Analysis ◽

Risk Difference ◽

World Health ◽

Cochrane Library ◽

Control Group ◽

Number Needed To Treat ◽

Receptor Antagonists ◽

Increased Risk ◽

Health Organization

Abstract Background We systematically reviewed the literature to answer the following research questions: (1) Does interleukin 6 (IL-6) (receptor) antagonist therapy reduce mortality in coronavirus disease 2019 (COVID-19) patients compared to patients not treated with IL-6 (receptor) antagonists; and (2) is there an increased risk of side effects in COVID-19 patients treated with IL-6 (receptor) antagonists compared to patients not treated with IL-6 (receptor) antagonists? Methods We systematically searched PubMed, PMC PubMed Central, Medline, World Health Organization COVID-19 Database, Embase, Web of Science, Cochrane Library, Emcare, and Academic Search Premier (through 30 June 2020). Random effects meta-analysis was used to pool the risk ratios and risk differences of individual studies. Risk of bias was appraised using the Methodological Index for Non-randomized Studies (MINORS) checklist. Results The search strategy retrieved 743 unique titles, of which 10 studies (all on tocilizumab [TCZ]) comprising 1358 patients were included. Nine of 10 studies were considered to be of high quality. Meta-analysis showed that the TCZ group had lower mortality than the control group. The risk ratio was 0.27 (95% confidence interval [CI], .12–.59) and the risk difference was 12% (95% CI, 4.6%–20%) in favor of the TCZ group. With only a few studies available, there were no differences observed regarding side effects. Conclusions Our results showed that mortality was 12% lower for COVID-19 patients treated with TCZ compared with those not treated with TCZ. The number needed to treat was 11, suggesting that for every 11 (severe) COVID-19 patients treated with TCZ, 1 death is prevented. These results require confirmation by randomized controlled trials.

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