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Study of Nicotine Patches in Patients With Sarcoidosis

quincycat
2 Recommendations

Always interesting to see new research in sarcoidosis, especially using existing treatments. This one stands out in trying to use nicotine as a therapy. Study is not yet enrolling, but will be recruiting at Ohio State Univ shortly.

From http://clinicaltrials.gov/ct2/show/NCT00701207

Detailed Description:
Until recently, there was no good explanation for the fact that smoking cigarettes actually reduces the risk of sarcoidosis. Research studies have shown that the nicotine, a common component of cigarette smoke, strongly suppresses the immune system and reduces the type of inflammation that is characteristic of sarcoidosis in the lungs. We propose that nicotine treatment, administered in the form of a skin patch, will reduce the severity of lung disease in patients with sarcoidosis. Sarcoidosis patients who volunteer to participate in this study will submit standardized questionnaires relating to their quality of life and the severity of their shortness of breath before and after treatment. We will also compare objective measures of lung function, radiographic parameters, and the severity of lung inflammation. We predict that nicotine treatment will reduce the severity of sarcoidosis symptoms, improve lung function, and resolve lung inflammation. If our hypothesis is proven to be correct in this relatively small group of patients, we will perform additional studies in a larger group of patients and will consider the features of sarcoidosis patients that predict a favorable response to nicotine and other nicotine-like drugs. If nicotine is ultimately found to be an effective treatment for sarcoidosis, it may replace some of the existing treatments which are frequently ineffective and have unacceptable side-effects.

Explore topics in this discussion:

Exercise Cancer Claritin Imuran Plaquenil Nicotine gum Allegra Pneumonia Prednisone Sarcoidosis Allergies Nicotine patch Fever Pain Heart attack Lyrica Neurontin Methotrexate

30 replies

BGUY

Any thing for a trial,hope the nicotine patch show some positive results for the lung,what should we try for the other organs and systems that are affected?.
such as spleen,liver,nervous system.

Blkjewelz8960

I stopped smoking once diagnosed with Sarc -- my pulmonary doctor said to quite smoking IMMEDIATELY and that is how he wrote it on my chart. If the doctor says that and my Sarc developed while smoking how is a patch that administers the same chemicals as smoking stop Sarc????

They are probably trying to do research on the affects of weaning Sarc patients off cigarettes with the patch.

I don't feel Sarc is misdiagnosed as much in people who smoke. It is initially thought to be cancer, TB, or pneumonia when it presents on xrays. But as the onocologist and thoratic surgeon look at xrays, mris, and ct scans, they will tell you Sarc in the lungs does not look the same or follow the path of cancer.

I would not enter into that trial. Thanks but no thanks.

gonenatural

The patches didn't help me. As time went on I became worse, not better, at all.
I didn't use them for too long, forget how long, because they wouldn't stay on and neither would the medical tape I was using to tape them on.

Ellen

Quincycat

I snmoked from 16 to 60 and was on the patches, the gum the lozenges. I couldn't breate. I was diagnosed around thirty. Pneumonia a stap infection and being on life support for a month got me away from the butts. I was unconscious during withdrawal. Should have done that before. {HAHA] I have emphezema but after not smoking for two years I am breathing pretty well. I have not had a cat scan lately because in ayear I think I had 28 years of radition.
I had the sarcoid all over my chest up to my throat. I damn well know it must have diminished.
When I was in rehab this elderly smoked. She swore it helped her Parkinsen"s. Of course she started smoking when she was in her seveties. Kind of funny but she could die of something else before she feels the effects of smoking.
I am very doubtful that nicotine is good for anything.
Ellen and GOOD LUCK

ILOVEMYHUSBAND

I know I have posted this before, but I really am interested in this study as my husband who chewed for 30 years, got sick, symptoms of fatigue and pain in chest, quit due to feeling so bad, then started to chew the nicotine gum and it made him feel better, not sure if that could be due to nicotine being a stimulant(thus helping fatigue) or otherwise. The doctor diagnosed sarc, but thought he had had it for a long time, just got diagnosed when ruling out cancer. No lung involvement yet and still just has the fatigue and nausea in the morning. Being an outsider, I know I should not have written "just" when talking about the fatigue and nausea, sorry.

JC7

Hi all, just throwing in my 2 cents... I too quit smoking just 1 month prior to my diagnosis. I know refering to the "House" episode on Sarc is silly, but???? Who knows? Hey, it's all a crap shoot, no? The best thing about Sarc, it's forced me to become more aware of what I put in my body and how it reacts...not a bad thing. Take care.

jeanie33

Fascinating posts, Pris, understand your frustrations with docs. Does anyone remember the episode on House when one of his patients finally had sarc but it was masked because he used to chew tobacco?
Admitedly I am a member of "never smoked" club -could have sworn second hand smoke was a trigger.
Either way it is an interesting study, more will be revealed.
j

OkieTokie

I use smokeless tobacco.
Taylors Pride Plug is my chew of choice.
I KNOW that I feel better when I am using than when I don't.

I know, the increase in bad stuff in just withdrawal from the tobacco. OR IS IT???

Maybe the rebound in sarc sympt is what is causing the bad buzz.

OUR Congress raising the tax on tobacco products is causing my home remedies to be as expensive as my rx drugs.

We are from the government.
We are here to help you.
Right.

party on
ot

kimkahuna

Google Parkinson's and nicotine.

priscurl

Hi Paradox,

I wasn't having a go at you personally. It's just that my aunt is having her fifth hip operation in four years and for the most recent one she is still having rehab. Her first day in rehab she dislocated it and she had to be readmitted to the emergency section of the hospital she had just come from. Not only that, I feel the pain of all the people here searching for a diagnosis. I knew what that was like myself. The human body itself is an untrustworthy thing. It was just frustrated last night. Hope you will forgive me.

Paradox

Oh - for the record - I am not making excuses for the physician in the above case. The details of the case are a bit more intricate, but the doc who made the decision to give the lethal drug most certainly made a mistake.

Paradox

Pris,

I think you actually make my point for me. Doctors are also human and prone to the same errors in thinking and that is what Dr. Groopman is referring to in his book. It isn't that "science clouds the issue" as much as the thinking patterns of people do. Science is matter of facts. Medicine is objective at it's ideal state. The errors that occur in the medical system are due to errors in thinking or knowledge and not malicious intent (I hope - certainly that would be the exception).
Case in point. A doctor sees a patient who is brought in having horrible deblilitating chest pain. The male patient is showing classic signs of acute MI (heart attack) and an EKG tracing does show disturbance. This is a common diagnosis and in this case the doctor immediately concludes that a heart attack is the issue and administers a medicine to break up clots in the blood vessels feeding the heart. This might have worked if the diagnosis had been right - instead it killed the patient because the data pool was incomplete. A simple chest X-ray would have shown the aorta was enlarged because it was torn - giving drugs to stop clotting allowed the patient to bleed to death.
This case is a quick summary of a very real case. There is no error in "science" or in the facts - just an incomplete data collection and a jumping to conclusions by the physician on duty who had likely seen at least 3 other heart attacks that day, all of which were heart attacks.
Again, not science clouding the facts, human nature and thought patterns do. It is the very reason we need the objective and structured boundries of science to achieve any model of what the real truth is.

quincycat

And Krissy -- to your question...
This particular study is only looking at lung inflammation as a primary outcome. (So the primary outcome is not function, nor impact on any other organ involved -- although function is being looked at in the study). Participants must have lung involvement.

Also, I do not believe that the take-away is that taking up smoking reduces symptoms (I will have a hard time sleeping tonite if people read this thread and decide to pick up a pack of Lucky's as a therapy). I think the history here is that smokers have a lower rate of sarcoidosis than non-smokers (of course, they are busy killing off their lungs in a different way).

quincycat

Don't try this at home...

OK. The intent of my posting the link was really meant to be informational; looking at nicotine may provides clues to the pathway of sarcoidosis.

But please talk to your doc before trying this on your own as a self-administered therapy? Keep in mind that with a "sample size of one" you will never really know if treating yourself in this way did benefit or harm (relative to the course your disease may have been taking).

Cheesypops

Krissy

I think the difference between the patch and smoking the real deal (ahem...let me rephrase that one)...CIGS...

Is you dont get all the excess tar and or bs that is an additive. Not to assume or infer that you don't understand that. I just may have read your post incorrectly.

And I think the Immune response vs the symptom discussion is alot like chicken and the egg trevor. I have done immunomodulators for MS...and currently do not take them now...but yet the only noticeable difference is hte lack of illness for 24 hrs per week.

Sure every doctor will have there own track they follow, position they take and course of treatment they adhere to. But to generalize all doctors as..."them types" ....I just cant get my head around that one pris.

And to top that all off...Your stepping on Doc P's toes during a taper....man...I wouldnt expect anyother response...:)

Light one up people and relax...creative discussions without getting personal are always the best way to finding solutions..

priscurl

Matters of fact??????
You could go to twenty doctors, get the same tests done with the exact same results and get twenty different answers, opinions, and medications.

Medicine is as still much art as science.

In fact, isn't Dr Groopman's book about the fact that science often clouds the issue.

Let's not forget that two jumbo jets full of people die each day in Australia from health system errors.

Pris (sorry to be a doctor basher Paradox but they have seriously added to my suffering and also to the suffering of people I love).

priscurl

Well hear's my two cents. My sarcoid went into remission on low dose pulsed prednisone. It had not been in remission for the four years prior to diagnosis (1995 - 2001) basically (offic. diag 1999). It just kept getting gradually worse. In 2001, I met with an immuno who agreed I was bad enough to try the pred. Remission. Blissful remission. I was out of pain for the first time in about 7 years and doing normal things, also lost weight with diet and exercise. In 2003, it was back with glands up, night sweats so bad I would have to change my sheets and nightclothes in the middle of the night after showering and washing my hair. I was on pred again, but I never went fully into remission with it, although my blood tests returned to normal bar the eosinophils. Soon I had EN. It took six months to convince somebody to look into it properly. Sure enough all the bloods and x-rays were abnormal again. Then they took me off all my medication, everything for four to five months (this is in 2006 so for six years I had been on plaquenil) while they decided whether I had a bleeding ulcer. By that time neurosarc had set in but good. I hardly ate or slept for four to five months while the %$****@$ faffed around with neurontin, Lyrica and methotrexate. I went to my local doctor and announced I had put myself on 30mg of prednisone and the thing thankfully cleared up within two weeks. However, other sarcoid symptoms have persisted. I was put on Imuran around that time, and was on it until Feb this year. It is exactly a year since I came off pred and the bloods are still not back to normal, in fact they are getting worse and frankly, I am %%%%%***%$ past caring.
My first immuno warned me that people she had observed who had had prednisone usually worsened on it, and I believe there are studies that indicate this. The first three doctors I saw over sarcoidosis refused to prescribe it on those grounds and also those that the risks outweighed the benefits.

I believe from this and other sarcoid experiences of purely my own, as well as certain peculiarities of the disease, that sarcoid is of infectious origin in the same manner as TB. Lots of people are exposed, but only those with the right genetic makeup or environmental risks actually get the disease.

It may be purely chance that non-smokers make up the bulk of those who get sarcoid. Perhaps there is a sampling error or perhaps patient's faced with the evidence they have a lung disease are too embarrassed or afraid to admit they smoke in front of their doc.

There's no way that I would be putting a known and maligned poison into the body. I think the whole idea is ridiculous. I would want to see the results of the trials (double blind placebo vs nicotine) before jumping into that pool.

A very hacked off pris (and it is 11.45 pm)

Cloudnine

Okay scratch my questions, I looked it up. Yes, it has been used already in other diseases and not only as an immune-suppressant, also as an anti-inflammatory. I am not going to list what it has been used for. I don't want to encourage the misuse of anything. It was not used for lungs in the studies I reviewed Krissy if that answers your question. I only briefly scanned the articles.

Cloudnine

Hm, I knew I missed some dirty habits along the way in life. Slaps self in the forehead, accidentally causing small abrasion to forehead. Searches around in medicine cabinet, doesn't find one stinking band-aid. Grabs next best thing, the nicotine patch.

AAAAHHHH! much better!

If nicotine is an immune-suppressant can this patch be used for other diseases? Has it been studied in other diseases? I am kind of thinking out loud, but if someone knows the answer, I am interested.

Krissy

Here it is again. This confuses me. Is the study to show that it improves "the condition of the lungs" or the symptoms of sarcoidosis? The symptoms of sarcoidosis are not just on the lungs. Does it alleviate other symptoms or just the lungs? Obviously there has been some improvement somewhere with some people for notice to be taken about nicotene. Did the smokers who noticed improvement notice it on the lungs or all their sarcoidosis symptoms? If they just had improvement on their lungs, will the patches do the same for them as smoking the dreaded stuff did? This will be an interesting study.

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Help and information from FSR

Sarcoidosis and the Body
Sarcoidosis is a "multiorgan" disease - meaning it almost always involves more than one organ. It's unpredictable and affects different people in different ways.

You can learn about the ways in which sarcoidosis affects the body in FSR's Sarcoidosis and the Body brochure.

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