戒烟药物方法：近期进展
2010/09/14
摘要
背景：虽然在发达国家，如美国和澳大利亚，其吸烟人群呈现缩小的趋势，但在全世界范围内，吸烟仍是造成疾病负担的一个主要因素。在东南亚地区，吸烟人群的比率仍然较高，烟草相关疾病的发病率持续增加。
方法：本文对2004年～2010年发表的，阐述尼古丁的药理学、检测戒烟治疗疗效的方法，及戒烟药物治疗的随机对照试验和系统综述进行综述。我们主要关注与目前常用的三种一线戒烟治疗药物：尼古丁替代治疗（NRT）、安非他酮和伐尼克兰。
结果：随机对照试验和荟萃分析显示，与安慰剂相比，单独采用NRT、安非他酮和伐尼克兰都能有效戒烟。NRT单药治疗的戒断率在13.3～19％，而安慰剂为7.5～14%；安非他酮单药治疗的戒断率在19～19.7%，而安慰剂为10.9～11%；伐尼克兰单药治疗的戒断率在25.5～25.6%，而安慰剂为11.2～14.8%。在目前的治疗药物中，伐尼克兰的戒烟效果更有效。一些联合治疗，如一种或两种剂型的NRT或者NRT加安非他酮治疗，效果优于单药治疗。目前为止，尚未有伐尼克兰联合NRT或安非他酮的随机对照试验。
结论：需要更多的研究来阐明上述治疗的最佳疗程以及联合治疗的安全性和有效性。上市后调查在监测药物相关性不良反应中具有重要意义。
（林江涛 审校）
Cardiovasc Drugs Ther. 2010 Jul 3. [Epub ahead of print]
Smoking Cessation-Recent Advances
McNeil JJ, Piccenna L, Ioannides-Demos LL.
Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Victoria, 3004, Australia, john.mcneil@med.monash.edu.au.
Abstract
BACKGROUND: Smoking continues to be a major contributor to the burden of disease across the world although there has been a decrease in some developed countries such as USA and Australia. In countries of South-East Asia with a high prevalence of smoking, the incidence of tobacco-related diseases will continue to increase.
METHODS: We reviewed the literature in relation to the pharmacology of nicotine, the measures used to determine the efficacy of anti-smoking therapies, and the randomised controlled trials and systematic reviews of pharmacotherapies published between 2004 and 2010. We focused primarily on the three first line therapies that are currently available: nicotine replacement therapy (NRT), bupropion and varenicline.
RESULTS: Randomised controlled trials and meta-analyses have demonstrated that single therapy with either NRT, bupropion or varenicline are all more effective than placebo for smoking cessation. Abstinence rates for monotherapies varies from 13.3% to 19% for NRT compared to 7.5% to 14% for placebo, 19% to 19.7% for bupropion versus 10.9% to 11% for placebo and 25.5% to 25.6% for varenicline versus 11.2% to 14.8% for placebo. Of current therapies varenicline appears to be more effective at achieving abstinence. Some combination therapies with one or two formulations of NRT or NRT plus bupropion have demonstrated superior results to monotherapy. To date there are no randomised controlled trials of varenicline in combination with NRT or bupropion.
CONCLUSION: Further studies are required to address the uncertainty that exists on the most appropriate duration of therapy as well as the effectiveness and safety of combination pharmacotherapy. Post-marketing surveillance continues to play an important role in monitoring the adverse effects events associated with these therapies.
Cardiovasc Drugs Ther. 2010 Jul 3. [Epub ahead of print]
背景：虽然在发达国家，如美国和澳大利亚，其吸烟人群呈现缩小的趋势，但在全世界范围内，吸烟仍是造成疾病负担的一个主要因素。在东南亚地区，吸烟人群的比率仍然较高，烟草相关疾病的发病率持续增加。
方法：本文对2004年～2010年发表的，阐述尼古丁的药理学、检测戒烟治疗疗效的方法，及戒烟药物治疗的随机对照试验和系统综述进行综述。我们主要关注与目前常用的三种一线戒烟治疗药物：尼古丁替代治疗（NRT）、安非他酮和伐尼克兰。
结果：随机对照试验和荟萃分析显示，与安慰剂相比，单独采用NRT、安非他酮和伐尼克兰都能有效戒烟。NRT单药治疗的戒断率在13.3～19％，而安慰剂为7.5～14%；安非他酮单药治疗的戒断率在19～19.7%，而安慰剂为10.9～11%；伐尼克兰单药治疗的戒断率在25.5～25.6%，而安慰剂为11.2～14.8%。在目前的治疗药物中，伐尼克兰的戒烟效果更有效。一些联合治疗，如一种或两种剂型的NRT或者NRT加安非他酮治疗，效果优于单药治疗。目前为止，尚未有伐尼克兰联合NRT或安非他酮的随机对照试验。
结论：需要更多的研究来阐明上述治疗的最佳疗程以及联合治疗的安全性和有效性。上市后调查在监测药物相关性不良反应中具有重要意义。
（林江涛 审校）
Cardiovasc Drugs Ther. 2010 Jul 3. [Epub ahead of print]
Smoking Cessation-Recent Advances
McNeil JJ, Piccenna L, Ioannides-Demos LL.
Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Victoria, 3004, Australia, john.mcneil@med.monash.edu.au.
Abstract
BACKGROUND: Smoking continues to be a major contributor to the burden of disease across the world although there has been a decrease in some developed countries such as USA and Australia. In countries of South-East Asia with a high prevalence of smoking, the incidence of tobacco-related diseases will continue to increase.
METHODS: We reviewed the literature in relation to the pharmacology of nicotine, the measures used to determine the efficacy of anti-smoking therapies, and the randomised controlled trials and systematic reviews of pharmacotherapies published between 2004 and 2010. We focused primarily on the three first line therapies that are currently available: nicotine replacement therapy (NRT), bupropion and varenicline.
RESULTS: Randomised controlled trials and meta-analyses have demonstrated that single therapy with either NRT, bupropion or varenicline are all more effective than placebo for smoking cessation. Abstinence rates for monotherapies varies from 13.3% to 19% for NRT compared to 7.5% to 14% for placebo, 19% to 19.7% for bupropion versus 10.9% to 11% for placebo and 25.5% to 25.6% for varenicline versus 11.2% to 14.8% for placebo. Of current therapies varenicline appears to be more effective at achieving abstinence. Some combination therapies with one or two formulations of NRT or NRT plus bupropion have demonstrated superior results to monotherapy. To date there are no randomised controlled trials of varenicline in combination with NRT or bupropion.
CONCLUSION: Further studies are required to address the uncertainty that exists on the most appropriate duration of therapy as well as the effectiveness and safety of combination pharmacotherapy. Post-marketing surveillance continues to play an important role in monitoring the adverse effects events associated with these therapies.
Cardiovasc Drugs Ther. 2010 Jul 3. [Epub ahead of print]
上一篇：
尼古丁替代治疗戒烟的不良反应：对177390人参与的120个研究进行的系统综述和荟萃分析
下一篇：
在寻求戒烟治疗的年轻吸烟者中采用尼古丁替代治疗
