Médecine

Paramédical

Autres domaines


S'abonner

Transdermal nicotine in non-smokers: A systematic review to design COVID-19 clinical trials - 06/12/21

Doi : 10.1016/j.resmer.2021.100844 
B. Dautzenberg a, b, , A. Levi c, M. Adler d, R. Gaillard c, e, f
a APHP Sorbonne University, Pitié-Salpêtrière Hospital, 75013 Paris, France 
b Institut Arthur Vernes, Smoking Cessation Unit, 75006 Paris, France 
c Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 75014 Paris, France 
d Smoking Cessation Unit, Hôpital Antoine, Béclère APHP, 92140 Clamart, France 
e Université de Paris, 75006 Paris, France 
f Unité de Neuropathologie expérimentale, Département Santé Globale, Institut Pasteur, 75015 Paris, France 

Corresponding author at: 14, avenue Bosquet, 75007 Paris.14, avenue BosquetParis75007

Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.

Connectez-vous pour en bénéficier!

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.

Le texte complet de cet article est disponible en PDF.

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


© 2021  Publié par Elsevier Masson SAS.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 80

Article 100844- novembre 2021 Retour au numéro
Article précédent Article précédent
  • The effect of statin therapy on disease-related outcomes in idiopathic pulmonary fibrosis: A systematic review and meta-analysis
  • J.W. Kim, K. Barrett, Y. Loke, A.M. Wilson
| Article suivant Article suivant
  • The association between sleep-related breathing disorders and pre-capillary pulmonary hypertension: A chicken and egg question
  • R. Esnaud, F. Gagnadoux, A. Beurnier, A. Berrehare, W. Trzepizur, M. Humbert, D. Montani, E.-M. Jutant

Bienvenue sur EM-consulte, la référence des professionnels de santé.

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.