Piotr Tutka1,2,3, Denis Vinnikov4,5, Ryan J Courtney3, Neal L Benowitz6,7. 1. Department of Experimental and Clinical Pharmacology, University of Rzeszów, Rzeszów, Poland. 2. Laboratory for Innovative Research in Pharmacology, University of Rzeszów, Rzeszów, Poland. 3. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. 4. School of Public Health, Al-Farabi Kazakh National University, Almaty, Kazakhstan. 5. Biological Institute, National Research Tomsk State University, Tomsk, Russia. 6. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California San Francisco, San Francisco, CA, USA. 7. Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA.
Abstract
AIMS: To review cytisine's history of use, pre-clinical evidence, clinical pharmacokinetics, efficacy, adverse reactions (ARs) and safety for smoking cessation. METHODS: A synoptic review of the use of cytisine as a smoking cessation medication, mechanism of action, pharmacokinetics and safety. Relevant literature on data included in these sections were identified through a search of 11 databases with additional literature obtained from reports and monographs. Three databases (PubMed, EMBASE and www.elibrary.ru) were systematically searched for studies published from 2012 to August 2018 in any language to provide an updated meta-analysis of cytisine's efficacy and ARs for smoking cessation compared with placebo. We pooled the relative risks (RR) of abstinence in the efficacy analysis and RR of ARs, either reported by the authors or calculated from the reports. RESULTS: Cytisine has been in use since 1964 and is currently marketed in 18 countries. Systemic bioavailability from oral ingestion is high and clearance is primarily renal, with minimal or no metabolism. Brain uptake in animal models is moderate. The plasma half-life averages 4.8 hours. Eight studies were included for meta-analysis of efficacy. With heterogeneous results, the overall RR versus placebo of successful continuous abstinence at the longest follow-up was 1.74 [95% confidence interval (CI) = 1.38-2.19]. Nausea, vomiting, dyspepsia, upper abdominal pain and dry mouth that were mild or moderate were the most common ARs, with RR versus placebo 1.10 (95% CI = 0.95-1.28). The cost of cytisine in eastern and central Europe is several-fold less than that of other smoking cessation medications. CONCLUSIONS: Cytisine is a low-cost medication found to increase the likelihood of smoking cessation. The most frequently reported ARs of cytisine involve gastrointestinal symptoms that are mostly reported as either mild or moderate in severity.
AIMS: To review cytisine's history of use, pre-clinical evidence, clinical pharmacokinetics, efficacy, adverse reactions (ARs) and safety for smoking cessation. METHODS: A synoptic review of the use of cytisine as a smoking cessation medication, mechanism of action, pharmacokinetics and safety. Relevant literature on data included in these sections were identified through a search of 11 databases with additional literature obtained from reports and monographs. Three databases (PubMed, EMBASE and www.elibrary.ru) were systematically searched for studies published from 2012 to August 2018 in any language to provide an updated meta-analysis of cytisine's efficacy and ARs for smoking cessation compared with placebo. We pooled the relative risks (RR) of abstinence in the efficacy analysis and RR of ARs, either reported by the authors or calculated from the reports. RESULTS:Cytisine has been in use since 1964 and is currently marketed in 18 countries. Systemic bioavailability from oral ingestion is high and clearance is primarily renal, with minimal or no metabolism. Brain uptake in animal models is moderate. The plasma half-life averages 4.8 hours. Eight studies were included for meta-analysis of efficacy. With heterogeneous results, the overall RR versus placebo of successful continuous abstinence at the longest follow-up was 1.74 [95% confidence interval (CI) = 1.38-2.19]. Nausea, vomiting, dyspepsia, upper abdominal pain and dry mouth that were mild or moderate were the most common ARs, with RR versus placebo 1.10 (95% CI = 0.95-1.28). The cost of cytisine in eastern and central Europe is several-fold less than that of other smoking cessation medications. CONCLUSIONS:Cytisine is a low-cost medication found to increase the likelihood of smoking cessation. The most frequently reported ARs of cytisine involve gastrointestinal symptoms that are mostly reported as either mild or moderate in severity.
Authors: Sara M Zarate; Gauri Pandey; Sunanda Chilukuri; Jose A Garcia; Brittany Cude; Shannon Storey; Nihal A Salem; Eric A Bancroft; Michelle Hook; Rahul Srinivasan Journal: J Neurochem Date: 2021-01-10 Impact factor: 5.372
Authors: Hilary A Tindle; Matthew S Freiberg; Natalia Gnatienko; Elena Blokhina; Debbie M Cheng; Tatiana Yaroslavtseva; Sally Bendiks; Michael Winter; Evgeny Krupitsky; Jeffrey H Samet Journal: Contemp Clin Trials Commun Date: 2020-07-16
Authors: Ryan J Courtney; Hayden McRobbie; Piotr Tutka; Natasha A Weaver; Dennis Petrie; Colin P Mendelsohn; Anthony Shakeshaft; Saki Talukder; Christel Macdonald; Dennis Thomas; Benjamin C H Kwan; Natalie Walker; Coral Gartner; Richard P Mattick; Christine Paul; Stuart G Ferguson; Nicholas A Zwar; Robyn L Richmond; Christopher M Doran; Veronica C Boland; Wayne Hall; Robert West; Michael Farrell Journal: JAMA Date: 2021-07-06 Impact factor: 56.272
Authors: Anna Petruczynik; Karol Wróblewski; Justyna Misiurek; Tomasz Plech; Karolina Szalast; Krzysztof Wojtanowski; Tomasz Mroczek; Grażyna Szymczak; Monika Waksmundzka-Hajnos; Piotr Tutka Journal: Toxins (Basel) Date: 2020-08-29 Impact factor: 4.546