Westergaard Christian G, Porsbjerg Celeste, Backer Vibeke
Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark.
Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark.
Respir Med. 2015 Nov;109(11):1416-22. doi: 10.1016/j.rmed.2015.07.017. Epub 2015 Jul 30.
Tobacco use causes long-term morbidity and mortality. In patients with asthma, the frequency of smokers is high; however, asthmatic smokers experience more pronounced symptoms, accelerated loss of lung function and treatment resistance. Varenicline is an effective drug in smoking cessation, when investigated in COPD patients and general populations. The aim of the present study was to evaluate the effect of Varenicline on tobacco cessation in young asthmatics.
In a randomized, placebo-controlled, double-blinded trial, 52 asthmatic current smokers (age 19-40) ≥ 10 cigarettes daily and ≥10 packyears (mean 15.6) were recruited to a 12 week treatment period with Varenicline or placebo (1:1) in parallel design. Evaluation of smoking status, asthma symptom score, general health quality score and methacholine challenge were performed at week 0, week 6, week 12 and week 24.
In the Varenicline group, at week 12, 69% of the patients quit smoking vs. 36% in the placebo group (p = 0.017, intended-to-treat analysis), but after 24 weeks, a high relapse rate was present (quit rates 19% vs. 16%, NS). After 6 weeks of treatment, significant improvements in airway hyperresponsiveness (AHR) in the Varenicline group was found (from 88% to 58%, p = 0.016), whereas no change was observed in the placebo group. Symptom score and general health quality improved in both the Varenicline and the placebo group.
We demonstrated that Varenicline can be used with a high probability of success with tobacco cessation in young smokers with asthma, but relapse rate after end of treatment is high. Quitting smoking can improve asthma control.
吸烟会导致长期发病和死亡。哮喘患者中吸烟者的比例较高；然而，哮喘吸烟者的症状更为明显，肺功能丧失加速且存在治疗抵抗。在慢性阻塞性肺疾病（COPD）患者和普通人群中进行研究时，伐尼克兰是一种有效的戒烟药物。本研究的目的是评估伐尼克兰对年轻哮喘患者戒烟的效果。
在一项随机、安慰剂对照、双盲试验中，招募了52名每日吸烟≥10支且吸烟史≥10包年（平均15.6包年）的19至40岁哮喘现吸烟者，进行为期12周的伐尼克兰或安慰剂（1:1）平行设计治疗。在第0周、第6周、第12周和第24周对吸烟状况、哮喘症状评分、总体健康质量评分和乙酰甲胆碱激发试验进行评估。
在伐尼克兰组，第12周时，69%的患者戒烟，而安慰剂组为36%（p = 0.017，意向性分析），但24周后，复发率较高（戒烟率分别为19%和16%，无统计学差异）。治疗6周后，发现伐尼克兰组的气道高反应性（AHR）有显著改善（从88%降至58%，p = 0.016），而安慰剂组未观察到变化。伐尼克兰组和安慰剂组的症状评分和总体健康质量均有所改善。
我们证明，伐尼克兰用于年轻哮喘吸烟者戒烟有很高的成功率，但治疗结束后的复发率较高。戒烟可改善哮喘控制。
