Paul M Cinciripini1, Charles E Green2, Jason D Robinson3, Maher Karam-Hage3, Jeffrey M Engelmann3, Jennifer A Minnix3, David W Wetter4, Francesco Versace5. 1. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Unit 1330, PO Box 301439, Houston, TX, 77230-1439, USA. pcinciri@mdanderson.org. 2. The University of Texas at Houston Health Sciences Center, Houston, TX, USA. 3. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Unit 1330, PO Box 301439, Houston, TX, 77230-1439, USA. 4. University of Utah, Salt Lake City, UT, USA. 5. University of Oklahoma Health Sciences Center and Oklahoma Tobacco Research Center, Oklahoma City, USA.
Abstract
RATIONALE: We have shown that differences in the level of neural activation to stimuli associated with smoking vs. natural rewards, a biomarker related to reward sensitivity, predict treatment outcome. OBJECTIVES: This paper examined whether this biomarker moderates the impact of bupropion or varenicline on smoking cessation. METHODS: Prior to treatment randomization, smokers (N = 180) in a placebo-controlled trial using bupropion and varenicline completed event-related potential recording (late positive potential, LPP) while viewing pleasant (P), cigarette (C)-related, and other pictures. We used Bayesian models to estimate the probability of interaction between treatment and the LPP for both efficacy and comparative effectiveness analyses. RESULTS: Efficacy analysis showed that smokers with more neural activation to pleasant vs. cigarette-related stimuli (P > C) had a 98-99% chance of achieving greater abstinence than placebo (OR >1.00), using either medication from the end of treatment (EOT, primary outcome) through the 3-month follow-up. Relative to placebo, smokers with higher activation to cigarette-related vs. pleasant stimuli (C > P) had a 99% chance of increased benefit from varenicline at both time points (OR >1), but only 67 and 43% with bupropion at the EOT and 3-month follow-up, respectively. Comparative effectiveness analysis found that smokers with the C > P activation pattern had a 95-98% chance of benefit from varenicline vs. bupropion, while P > C smokers had a 50-58% chance of similar improvement with varenicline at the EOT and 3 months. CONCLUSIONS:Varenicline appears to be the treatment of choice for smokers with the C > P pattern of neural activation, while for those showing P > C, varenicline and bupropion have similar efficacy.
RCT Entities:
RATIONALE: We have shown that differences in the level of neural activation to stimuli associated with smoking vs. natural rewards, a biomarker related to reward sensitivity, predict treatment outcome. OBJECTIVES: This paper examined whether this biomarker moderates the impact of bupropion or varenicline on smoking cessation. METHODS: Prior to treatment randomization, smokers (N = 180) in a placebo-controlled trial using bupropion and varenicline completed event-related potential recording (late positive potential, LPP) while viewing pleasant (P), cigarette (C)-related, and other pictures. We used Bayesian models to estimate the probability of interaction between treatment and the LPP for both efficacy and comparative effectiveness analyses. RESULTS: Efficacy analysis showed that smokers with more neural activation to pleasant vs. cigarette-related stimuli (P > C) had a 98-99% chance of achieving greater abstinence than placebo (OR >1.00), using either medication from the end of treatment (EOT, primary outcome) through the 3-month follow-up. Relative to placebo, smokers with higher activation to cigarette-related vs. pleasant stimuli (C > P) had a 99% chance of increased benefit from varenicline at both time points (OR >1), but only 67 and 43% with bupropion at the EOT and 3-month follow-up, respectively. Comparative effectiveness analysis found that smokers with the C > P activation pattern had a 95-98% chance of benefit from varenicline vs. bupropion, while P > C smokers had a 50-58% chance of similar improvement with varenicline at the EOT and 3 months. CONCLUSIONS:Varenicline appears to be the treatment of choice for smokers with the C > P pattern of neural activation, while for those showing P > C, varenicline and bupropion have similar efficacy.
Authors: Thomas H Brandon; David J Drobes; Marina Unrod; Bryan W Heckman; Jason A Oliver; Richard C Roetzheim; Sloan Beth Karver; Brent J Small Journal: Psychopharmacology (Berl) Date: 2011-05-11 Impact factor: 4.530
Authors: Megan E Piper; Stevens S Smith; Tanya R Schlam; Michael C Fiore; Douglas E Jorenby; David Fraser; Timothy B Baker Journal: Arch Gen Psychiatry Date: 2009-11
Authors: Panayotis K Thanos; Nicholas B Taintor; Seth N Rivera; Hiroyuki Umegaki; Hiroyuki Ikari; George Roth; Donald K Ingram; Robert Hitzemann; Joanna S Fowler; S John Gatley; Gene-Jack Wang; Nora D Volkow Journal: Alcohol Clin Exp Res Date: 2004-05 Impact factor: 3.455
Authors: Jason D Robinson; Francesco Versace; Cho Y Lam; Jennifer A Minnix; Jeffrey M Engelmann; Yong Cui; Maher Karam-Hage; Sanjay S Shete; Gail E Tomlinson; Tina T-L Chen; David W Wetter; Charles E Green; Paul M Cinciripini Journal: Front Psychiatry Date: 2013-09-23 Impact factor: 4.157
Authors: David W Frank; Paul M Cinciripini; Menton M Deweese; Maher Karam-Hage; George Kypriotakis; Caryn Lerman; Jason D Robinson; Rachel F Tyndale; Damon J Vidrine; Francesco Versace Journal: Nicotine Tob Res Date: 2020-07-16 Impact factor: 4.244
Authors: Luba Yammine; Charles E Green; Thomas R Kosten; Constanza de Dios; Robert Suchting; Scott D Lane; Christopher D Verrico; Joy M Schmitz Journal: Nicotine Tob Res Date: 2021-08-29 Impact factor: 4.244
Authors: Francesco Versace; David W Frank; Elise M Stevens; Menton M Deweese; Michele Guindani; Susan M Schembre Journal: Psychophysiology Date: 2018-12-16 Impact factor: 4.016