Nicotine Replacement for Relapse

This pilot study suggests that nicotine replacement therapy has a short term, modest, but statistically significant improvement on three measures of HRQoL, when used in smoking cessation.

Every year during the last 5 years, around 47 million Americans can expect to have a relapse episode, and about 21 million will develop one. When relapse is examined by gender, it is most common in women and tends to occur more often after a period of remission, a condition known as relapsing-remitting type of arthritis.

A relapse is a return of a disease or symptoms that is related to the original illness. Relapse can occur in patients with many cancers (including breast cancer, lung cancer), including patients with cancer which is stable after treatment. The risk of a relapse after treatment is also a significant problem for women with breast cancer. Relapse may recur from months to many years after remission, and it may develop in response to new exposure to disease-causing environmental triggers including treatment. Relapse in a cancer patient typically does not occur because the disease dies off or changes into a different types of cells, but from new growth within a tumour or spread to another part of the body. Relapse rates with different types of cancer are about the same.

There were multiple factors that predicted a relapse in a study of over 80,000 patients treated in a community mental health service which included all the variables considered to affect outcome. The findings were particularly important because little is known about this group. Other studies are needed before they can influence treatment in a community mental health service.

Relapse to a new depressive episode can be prevented when treatments are adjusted and adjusted as needed to the needs and circumstances of each patient or group. If an antidepressant in good or very good maintenance tolerability is indicated, relapse is unlikely without ongoing treatment. Those who have not responded adequately to a regimen can be switched to a more active one. Treatment of relapse is often intensive including a combination of psychotherapy, mood stabilizer drugs, and, if necessary, electroconvulsive therapy or other psychiatric medications. Follow up and monitoring are essential for all patients treated in this way.

Relapse has been used as an indicator of treatment response because it represents the final stage of recovery. Most relapse is in the form of symptoms which may present months or years after initial recovery. Signs of relapse can be pain, swelling and redness, or muscle tenderness and limitation of activity.

The majority of the patients are able to be cured after relapses. Early identification, close follow-up and early treatment (a first course of chemotherapy) are necessary to prevent relapses and to maximize the prospects of cure.

Among this sample of smokers with a current or past history of addiction who were medically eligible for pharmacotherapies, there was a low rate of NRT use in combination with other pharmacotherapies. Among those smoking with a history of addiction, NRT was more commonly used in combination with BSSS, SSRIs, and bupropion.

There is no common cause of relapse in CLL. The current treatments reduce and monitor the clones responsible for relapse and so are very important for determining the risk of relapse.

In light of the recent results reported by Zablotsky (2010), with regard to the role of nicotine in reducing cancer risk, further large randomized controlled trials investigating potential synergistic effect of smoking cessation with the use of NRTIs are warranted.

Among patients that have undergone clinical trials to treat a relapse, patients that responded to their first treatment had the highest relapse rate at 2.13%. This suggests that a relapse of the disease should take into consideration the type of treatment that was administered to the patient.