Objectives
To determine if there were differential quit rates between AA and European
Americans (EA) with the experimental treatment naltrexone, and examine the role of
genetic ancestry on these outcomes among AAs.
Methods
Data from a previous randomized trial of 315 smokers to naltrexone vs. placebo
were reanalyzed using West African (WA) genetic ancestry to define sub-populations.
Logistic regression models were used to estimate treatment effects on early and end of
treatment quit rates, by race and WA ancestry.
Results
Among EAs (n=136), naltrexone significantly increased quit rates at four weeks
(62% vs. 43%, p=0.03) with directional, but not statistically significant effects at 12
weeks (30% vs. 18%, p=0.12). In contrast, among the AAs (n=95), quit rates did not
differ between naltrexone and placebo groups at either interval (four weeks: 43% vs.
32%, p=0.27; 12 weeks: 22% vs. 18%, p=0.60). A median split was conducted in AAs for WA
ancestry. Among AAs with low WA ancestry, quit rates were significantly higher with
naltrexone compared with placebo (60% vs. 27%, p=0.03). There was no advantage in quit
rates with naltrexone for the high WA ancestry group.
Conclusions
Naltrexone efficacy for smoking cessation varies across AA subjects with
different levels of WA ancestry. These results suggest that genetic background may
partially explain racial differences in drug response.