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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.
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.
There are ethnic differences in lung function, with white subjects having larger height-normalised forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) than black people or Asians [1,2]. It has been argued that these differences might be explained by environmental and social factors associated with poverty [3,4]. Alternatively, the differences in lung volume might be explained by inherent factors, such as genetically determined differences in body frame, with a relatively smaller thoracic cage and, consequently, smaller lungs in some Asian ethnic groups [4,5]. If the differences were explained mainly or entirely by environmental exposures, lung function in populations migrating from a south-Asian to a western European country should increase in successive generations as standards of living gradually approach those of the host region.We recently reported that FVC and FEV1 were 11% and 9% lower in UK-born south-Asian children compared with their white peers, but that these differences were not explained by cultural and socioeconomic indicators, perinatal data, environmental exposures, or personal or family history of wheeze [6]. However, such analyses always include the possibility of residual confounding by lifestyle factors or early-life environmental exposures that were not measured in the study and, hence, could not be accounted for in the analysis. If unmeasured environmental and lifestyle factors explain ethnic differences in lung function [7], we would expect the lung function of the offspring of mothers born and raised in the host country to be more similar to that of the native population than that of children born to immigrant mothers. We tested this hypothesis by comparing spirometry in two groups of UK-born south-Asian children: those with immigrant mothers and those with UK-born mothers.
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