Transdermal nicotine in non-smokers: A systematic review to design COVID-19 clinical trials - 06/12/21
, A. Levi c, M. Adler d, R. Gaillard c, e, f
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Highlights |
• | It has been hypothesized that nicotine use has a protective effect against COVID-19 infection. |
• | Tobacco use will never be the solution or a way to prevent illness. |
• | 33 studies report useful data on the use of transdermal nicotine to treat non-smokers with a variety of medical conditions. |
• | In 7.1% of cases included in these 33 studies, side effects required treatment to be stopped. |
• | Treatment initiation with a low dose of nicotine (for example, 3.5mg/24h) is suitable. |
• | A 2-week gradual increase of dose increases acceptance. |
• | Final target dose of 14mg/24h seems safe. |
• | There is a need for better assessment of the risk of nicotine dependence in such situations. |
Abstract |
Recent data show an interaction between COVID-19 and nicotine and indicate the need for an assessment of transdermal nicotine use in non-smokers. Assessments have been conducted into the short-term cognitive effects of nicotine and into diseases such as Parkinson's, Tourette syndrome, ADHD or ulcerative colitis.
Methods |
Analyses of nicotine administration protocols and safety were conducted after reviewing Medline and Science Direct databases performing a search using the words [transdermal nicotine] AND [non-smoker] AND selected diseases.
Results |
Among 298 articles identified, there were 35 reviewed publications reporting on 33 studies of non-smokers receiving transdermal nicotine for >48hours. In the 16 randomized trials, 7 crossover, 1 case/control and 9 open studies patients received an initial nicotine dose of between 2.5mg and 15mg/day. In 22 studies, daily doses increased by 2 to 7 steps in 3 to 96 days until the dose was between 5mg and 105mg/day. The target nicotine dose was 19.06±20.89mg/day. The 987 non-smokers (534 never-smokers, 326 ex-smokers and 127 classified as “non-smokers”) received or did not receive nicotine. The most common side-effects were nausea and skin itching. Forty-three (7.1%) non-smokers stopped treatment because of an adverse event of nicotine. No hospitalization related to nicotine side-effects were reported.
Conclusion |
Despite a relatively safe tolerance profile, transdermal nicotine therapy in non-smokers can only be used in clinical trials. There is a lack of formal assessment of the potential risk of developing a tobacco addiction. This review offers baseline data to set a transdermal nicotine protocol for non-smokers with a new purpose.
Le texte complet de cet article est disponible en PDF.Keywords : Transdermal nicotine, Non-smoker, Side-effects, Clinical trial, COVID-19
Plan
Vol 80
Article 100844- novembre 2021 Retour au numéro
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