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Relating Nicotine Plasma Concentration to Momentary Craving Across Four Nicotine Replacement Therapy Formulations
Author(s) -
Germovsek Eva,
Hansson Anna,
Kjellsson Maria C.,
Perez Ruixo Juan Jose,
Westin Åke,
Soons Paul A.,
Vermeulen An,
Karlsson Mats O.
Publication year - 2020
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.1595
Subject(s) - craving , nicotine , pharmacodynamics , nicotine replacement therapy , nicotine patch , smoking cessation , nicotine gum , potency , pharmacology , psychology , medicine , anesthesia , pharmacokinetics , chemistry , psychiatry , placebo , addiction , biochemistry , alternative medicine , pathology , in vitro
Tobacco use is a major health concern. To assist smoking cessation, nicotine replacement therapy ( NRT ) is used to reduce nicotine craving. We quantitatively described the relationship between nicotine pharmacokinetics ( PK s) from NRT s and momentary craving, linking two different pharmacodynamic ( PD ) scales for measuring craving. The dataset comprised retrospective data from 17 clinical studies and included 1,077 adult smokers with 39,802 craving observations from four formulations: lozenge, gum, mouth spray, and patch. A PK/PD model was developed that linked individual predicted nicotine concentrations with the categorical and visual analogue PD scales through a joint bounded integer model. A maximum effect model, accounting for acute tolerance development, successfully related nicotine concentrations to momentary craving. Results showed that all formulations were similarly effective in reducing craving, albeit with a fourfold lower potency for the patch. Women were found to have a higher maximal effect of nicotine to reduce craving, compared with men.