Shang Xue, Guo Kangle, E Fenfen, Deng Xinxin, Wang Yongsheng, Wang Ziyi, Wu Yanan, Xu Meng, Yang Chaoqun, Li Xiuxia, Yang Kehu
Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.
Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
Front Pharmacol. 2022 Oct 24;13:1012433. doi: 10.3389/fphar.2022.1012433. eCollection 2022.
A network meta-analysis based on randomized controlled trials was conducted to investigate the effects of pharmacological interventions on smoking cessation. English databases were searched to obtain randomized controlled trials reporting the effect of pharmacological interventions on smoking cessation. The risk of bias for the included trials was assessed using Cochrane Handbook tool. Stata 15.1 software was used to perform network meta-analysis, and GRADE approach was used to assess the evidence credibility on the effects of different interventions on smoking cessation. A total of 159 studies involving 60,285 smokers were included in the network meta-analysis. The analysis involved 15 interventions and which yielded 105 pairs of comparisons. Network meta-analysis showed that varenicline was more helpful for smoking cessation than other monotherapies, such as nicotine replacement therapy [Odds Ratio (OR) = 1.42, 95% confidence interval (CI) (1.16, 1.73)] and bupropion [OR = 1.52, 95% CI (1.22, 1.89)]. Furthermore, combined interventions were superior to monotherapy in achieving smoking cessation, such as varenicline plus bupropion over bupropion [OR = 2.00, 95% CI (1.11, 3.61)], varenicline plus nicotine replacement therapy over nicotine replacement therapy [OR = 1.84, 95% CI (1.07, 3.18)], and nicotine replacement therapy plus mecamylamine over naltrexone [OR = 6.29, 95% CI (1.59, 24.90)]. Finally, the surface under the cumulative ranking curve value indicated that nicotine replacement therapy plus mecamylamine had the greatest probability of becoming the best intervention. Most pharmacological interventions demonstrated a benefit in smoking cessation compared with placebo, whether monotherapy or combination therapy. Moreover, confirmed evidence suggested that some combination treatments, such as varenicline plus bupropion and nicotine replacement therapy plus mecamylamine have a higher probability of being the best smoking cessation in.
开展了一项基于随机对照试验的网状荟萃分析，以研究药物干预对戒烟的影响。检索英文数据库以获取报告药物干预对戒烟影响的随机对照试验。使用Cochrane手册工具评估纳入试验的偏倚风险。使用Stata 15.1软件进行网状荟萃分析，并使用GRADE方法评估不同干预措施对戒烟效果的证据可信度。网状荟萃分析共纳入159项研究，涉及60285名吸烟者。该分析涉及15种干预措施，产生了105对比较。网状荟萃分析表明，与其他单一疗法（如尼古丁替代疗法[比值比（OR）=1.42，95%置信区间（CI）（1.16，1.73）]和安非他酮[OR =1.52，95%CI（1.22，1.89）]）相比，伐尼克兰对戒烟更有帮助。此外，联合干预在实现戒烟方面优于单一疗法，如伐尼克兰加安非他酮优于安非他酮[OR =2.00，95%CI（1.11，3.61）]，伐尼克兰加尼古丁替代疗法优于尼古丁替代疗法[OR =1.84，95%CI（1.07，3.18）]，以及尼古丁替代疗法加美加明优于纳曲酮[OR =6.29，95%CI（1.59，24.90）]。最后，累积排序曲线下面积值表明，尼古丁替代疗法加美加明成为最佳干预措施的概率最大。与安慰剂相比，无论是单一疗法还是联合疗法，大多数药物干预在戒烟方面都显示出益处。此外，确凿证据表明，一些联合治疗，如伐尼克兰加安非他酮和尼古丁替代疗法加美加明，成为最佳戒烟方法的可能性更高。
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