重度和轻度烟草依赖患者使用尼古丁或伐尼克兰戒烟——一项荟萃分析的结果
Weaning From Tobacco with Nicotine or Varenicline in Severe and Mild Tobacco Dependence—Findings of a Meta-Analysis.
作者信息
Selbach Claudia, Siebel Christian, Lilienthal Jona, Grouven Ulrich, Knelangen Marco, Kastaun Sabrina, Kranz Philip
机构信息
Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany; Institute of General Practice (ifam), Centre for Health and Society, Medical Faculty and University Hospital of Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
出版信息
Dtsch Arztebl Int. 2025 Jan 10;122(1):7-11. doi: 10.3238/arztebl.m2024.0223.
BACKGROUND
Systematic reviews have documented the beneficial effects of bupropion, cytisine, nicotine, and varenicline as aids to permanent smoking cessation. We investigated the question whether the effect of treatment depends on the severity of tobacco dependence.
METHODS
We systematically searched for relevant publications in bibliographic databases and trial registries, made inquiries to manufacturers, and consulted additional sources of information (last search on 1 September 2022). The smokers included in the present study were classified as mildly or severely tobacco-dependent on the basis of their scores on the Fagerström Test for Nicotine Dependence, with variable cut-off values (FTND score 4, 5, or 6). In this meta-analysis, we determined the results with respect to the endpoint of sustained smoking cessation at 6 and 12 months in each of the two subgroups and investigated the heterogeneity between them.
RESULTS
No subgroup analyses that could enable us to answer the question posed in this meta-analysis were available for either bupropion or cytisine. Subgroup analyses were available for varenicline in 12 studies, involving a total of 9723 smokers, and for nicotine in 23, involving 15 003 smokers. No statistically significant heterogeneity (p > 0.05) between mildly and severely tobacco-dependent smokers was found for the effect of either drug on the endpoint sustained smoking cessation (at 6 and 12 months), and this was so independently of the FTND cut-off value that was used.
CONCLUSION
The benefit of varenicline and nicotine as aids to smoking cessation is independent of the severity of tobacco dependence.
背景
系统评价已证明安非他酮、金雀花碱、尼古丁和伐尼克兰有助于永久戒烟。我们研究了治疗效果是否取决于烟草依赖的严重程度这一问题。
方法
我们系统检索了文献数据库和试验注册库中的相关出版物，向制造商咨询，并查阅了其他信息来源（最后一次检索时间为2022年9月1日）。本研究纳入的吸烟者根据其尼古丁依赖程度弗格斯屈姆测试（Fagerström Test for Nicotine Dependence, FTND）的得分被分类为轻度或重度烟草依赖，采用不同的临界值（FTND得分4、5或6）。在这项荟萃分析中，我们确定了两个亚组中每组在6个月和12个月时持续戒烟这一终点的结果，并研究了它们之间的异质性。
结果
安非他酮或金雀花碱均没有可让我们回答本荟萃分析中提出问题的亚组分析。伐尼克兰有12项研究进行了亚组分析，共涉及9723名吸烟者；尼古丁有23项研究进行了亚组分析，涉及15003名吸烟者。对于这两种药物对持续戒烟终点（6个月和12个月时）的影响，在轻度和重度烟草依赖吸烟者之间未发现统计学上的显著异质性（p>0.05），且这与所使用的FTND临界值无关。
结论
伐尼克兰和尼古丁作为戒烟辅助药物的益处与烟草依赖的严重程度无关。
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