药物治疗以获得短期戒烟的有效性：系统综述和荟萃分析
2009/11/17
背景：戒烟对健康有立竿见影的益处。目前对各种戒烟干预措施的短期有效性尚不完全清楚。本试验比较使用尼古丁替代治疗（NRT）、安非他酮和伐尼克兰戒烟4周后的相对有效性。
方法：对10个电子数据库进行检索（截止到2008年10月），选择持续戒烟至少4周为主要终点的随机对照研究（RCTs）进行评估，采用生化方法确定是否戒烟。采用随机效应优势比（OR）荟萃分析和荟萃回归分析。使用一对一的研究比较各种干预措施的治疗效果，并计算间接对比结果。
结果：共检索到101项自戒烟之日起约4周后评估NRT与无活性对照药物比较的研究，共包括31,321例受试者。整合后的总OR为2.05（95%CI，1.89-2.23, P<0.0001）。综合31项研究安非他酮的试验（共包括11,118例受试者）数据后，总OR为2.25（95% CI, 1.94-2.62, P<0.0001）。对9项伐尼克兰与安慰剂对比的研究进行评价，发现自戒烟之日起第4周戒断的总OR为3.16 （95% CI, 2.55-3.91, P<0.0001）。2项试验对伐尼克兰和安非他酮进行了头对头研究，戒烟治疗第4周戒断的总OR为1.86（95% CI, 1.49-2.33, P<0.0001）。
间接对比包括：NRT和安非他酮，OR, 1.09, 95% CI, 0.93-1.31, P=0.28；瓦伦尼克林和NRT，OR 1.56, 95% CI, 1.23-1.96, P=0.0002；伐尼克兰和安非他酮，OR 1.40, 95% CI, 1.08-1.85, P=0.01。
结论：药物治疗能有效增加吸烟的短期戒断率。
（刘国梁 审校）
Harm Reduct J. 2009 Sep 18;6(1):25.
Efficacy of pharmacotherapies for short-term smoking abstinence: A systematic review and meta-analysis.
Mills EJ, Wu P, Spurden D, Ebbert J, Wilson K.
ABSTRACT: BACKGROUND: Smoking cessation has important immediate health benefits. The comparative short-term effectiveness of smoking cessation interventions is not well known. We aimed to determine the relative effectiveness of nicotine replacement therapy (NRT), bupropion and varenicline at 4 weeks post-target quit date.
METHODS: We searched 10 electronic medical databases (inception to October 2008). We selected randomized clinical trials [RCTs] evaluating interventions for our primary outcome of abstinence from smoking at at-least 4 weeks post-target quit date, with biochemical confirmation. We conducted random-effects odds ratio (OR) meta-analysis and meta-regression. We compared treatment effects across interventions using head-to-head trials and calculated indirect comparisons.
RESULTS: We combined a total of 101 trials evaluating delivery of NRT versus inert controls at approximately 4 weeks post-target quit date (total n=31,321). The pooled overall OR is OR 2.05 (95% Confidence Interval [CI], 1.89-2.23, P=<0.0001). We pooled data from 31 bupropion trials contributing a total n of 11,118 participants and found a pooled OR of 2.25 (95% CI, 1.94-2.62, P=<0.0001). We evaluated 9 varenicline trials compared to placebo. Our pooled estimate for cessation at 4 weeks post-target quit date found a pooled OR of 3.16 (95% CI, 2.55-3.91, P=<0.0001). Two trials evaluated head to head comparisons of varenicline and bupropion and found a pooled estimate of OR 1.86 (95% CI, 1.49-2.33, P=<0.0001 at 4 weeks post-target quit date.
Indirect comparisons were: NRT and bupropion, OR, 1.09, 95% CI, 0.93-1.31, P=0.28; varenicline and NRT, OR 1.56, 95% CI, 1.23-1.96, P=0.0002; and, varenicline and bupropion, OR 1.40, 95% CI, 1.08-1.85, P=0.01.
CONCLUSIONS: Pharmacotherapeutic interventions are effective for increasing smoking abstinence rates in the short-term.
Mills EJ, et al. Harm Reduct J. 2009 Sep 18;6(1):25.
方法：对10个电子数据库进行检索（截止到2008年10月），选择持续戒烟至少4周为主要终点的随机对照研究（RCTs）进行评估，采用生化方法确定是否戒烟。采用随机效应优势比（OR）荟萃分析和荟萃回归分析。使用一对一的研究比较各种干预措施的治疗效果，并计算间接对比结果。
结果：共检索到101项自戒烟之日起约4周后评估NRT与无活性对照药物比较的研究，共包括31,321例受试者。整合后的总OR为2.05（95%CI，1.89-2.23, P<0.0001）。综合31项研究安非他酮的试验（共包括11,118例受试者）数据后，总OR为2.25（95% CI, 1.94-2.62, P<0.0001）。对9项伐尼克兰与安慰剂对比的研究进行评价，发现自戒烟之日起第4周戒断的总OR为3.16 （95% CI, 2.55-3.91, P<0.0001）。2项试验对伐尼克兰和安非他酮进行了头对头研究，戒烟治疗第4周戒断的总OR为1.86（95% CI, 1.49-2.33, P<0.0001）。
间接对比包括：NRT和安非他酮，OR, 1.09, 95% CI, 0.93-1.31, P=0.28；瓦伦尼克林和NRT，OR 1.56, 95% CI, 1.23-1.96, P=0.0002；伐尼克兰和安非他酮，OR 1.40, 95% CI, 1.08-1.85, P=0.01。
结论：药物治疗能有效增加吸烟的短期戒断率。
（刘国梁 审校）
Harm Reduct J. 2009 Sep 18;6(1):25.
Efficacy of pharmacotherapies for short-term smoking abstinence: A systematic review and meta-analysis.
Mills EJ, Wu P, Spurden D, Ebbert J, Wilson K.
ABSTRACT: BACKGROUND: Smoking cessation has important immediate health benefits. The comparative short-term effectiveness of smoking cessation interventions is not well known. We aimed to determine the relative effectiveness of nicotine replacement therapy (NRT), bupropion and varenicline at 4 weeks post-target quit date.
METHODS: We searched 10 electronic medical databases (inception to October 2008). We selected randomized clinical trials [RCTs] evaluating interventions for our primary outcome of abstinence from smoking at at-least 4 weeks post-target quit date, with biochemical confirmation. We conducted random-effects odds ratio (OR) meta-analysis and meta-regression. We compared treatment effects across interventions using head-to-head trials and calculated indirect comparisons.
RESULTS: We combined a total of 101 trials evaluating delivery of NRT versus inert controls at approximately 4 weeks post-target quit date (total n=31,321). The pooled overall OR is OR 2.05 (95% Confidence Interval [CI], 1.89-2.23, P=<0.0001). We pooled data from 31 bupropion trials contributing a total n of 11,118 participants and found a pooled OR of 2.25 (95% CI, 1.94-2.62, P=<0.0001). We evaluated 9 varenicline trials compared to placebo. Our pooled estimate for cessation at 4 weeks post-target quit date found a pooled OR of 3.16 (95% CI, 2.55-3.91, P=<0.0001). Two trials evaluated head to head comparisons of varenicline and bupropion and found a pooled estimate of OR 1.86 (95% CI, 1.49-2.33, P=<0.0001 at 4 weeks post-target quit date.
Indirect comparisons were: NRT and bupropion, OR, 1.09, 95% CI, 0.93-1.31, P=0.28; varenicline and NRT, OR 1.56, 95% CI, 1.23-1.96, P=0.0002; and, varenicline and bupropion, OR 1.40, 95% CI, 1.08-1.85, P=0.01.
CONCLUSIONS: Pharmacotherapeutic interventions are effective for increasing smoking abstinence rates in the short-term.
Mills EJ, et al. Harm Reduct J. 2009 Sep 18;6(1):25.
上一篇：
预测戒烟效果持续性的前瞻性研究：一项随机对照临床试验结果
下一篇：
与传统治疗相比，戒烟治疗前使用尼古丁贴片能显著增加戒断率
