Trial Testing Nicotine Patch for Lung Inflammation

Elliott Crouser examining a patient (Ohio State University)

28 August 2017. A clinical trial is underway testing a nicotine patch worn to help stop smoking as a treatment for a chronic inflammatory disease affecting the lungs. The study is led by Elliott Crouser, a respiratory disease specialist at Ohio State University medical center in Columbus.

Crouser and colleagues are seeking better treatments for sarcoidosis, a disorder causing inflammation in the lungs, but also in lymph nodes or on the skin. The cause of the disease is unclear, with environmental factors, such as irritants in the air, considered a likely cause. The severity of symptoms varies, from no symptoms to coughing and shortness of breath, as well as fatigue, weight loss, and night sweats. It is not unusual, say the researchers, that the symptoms, many common to other disorders, result in the disease being misdiagnosed, confused with lung nodules, pneumonia, scar tissue, and lung cancer.

The most prescribed treatment for sarcoidosis is steroids, which is one reason why the Ohio State team is seeking alternative therapies. “We can’t use the medications for very long before these side effects occur,” says Crouser in a university statement. “They can be severe, such as the development of osteoporosis, cataracts, diabetes or high blood pressure and complications related to those.”

The idea of nicotine treating a lung disease may seem counter-intuitive, but in recent years some research shows nicotine can have anti-inflammatory effects. And earlier evidence suggests at least an association between cigarette smoking and a lower likelihood of sarcoidosis. The university says a pilot study shows nicotine patches may benefit people with the disorder.

The clinical trial, an early- and intermediate-stage study, aims to provide more solid evidence. The trial is recruiting 60 individuals with sarcoidosis, who are non-smokers, but taking the steroid prednisone or a similar anti-inflammatory drug. Participants are randomly assigned to wear the commercial Habitrol nicotine patch or a placebo patch for 7 months.

During the trial, participants are evaluated on their lung capacity with standard spirometry tests, as well as CT scans and computer models to assess progression of the disease. Individuals are also contacted monthly to check for adverse effects.

The team hopes the trial can provide tangible details about the disease that up to now remains largely a mystery. Crouser notes, for example, that Black women are at a higher risk for sarcoidosis, but no satisfactory explanation is yet provided. He attributes a greater diagnosis of the disorder to “increased awareness of the disease among the health care community and the use of more sensitive screening tests, such as CAT scans, which improves the detection of the disease.” Crouser adds, “It is also possible that something in the environment is triggering more cases of sarcoidosis.”

In the following video, Crouser tells more about the trial.

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