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Tratamientos farmacológicos para dejar de fumar
Kate Cahill1, Sarah Stevens2, Tim Lancaster1
1Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom2Cochrane Tobacco Addiction Group, University of Oxford, Oxford, United Kingdom.
JAMA
|January 9, 2014
Resumen
La terapia de reemplazo de nicotina (TRN) y el bupropión muestran mayores tasas de abandono del tabaquismo que el placebo. La vareniclina y la combinación de TRN son las más efectivas, sin eventos adversos graves relacionados con ningún tratamiento.
Área de la Ciencia:
- Farmacología Farmacología.
- Medicina de la adicción Medicina de la adicción
- Salud Pública La salud pública.
Sus antecedentes:
- Fumar sigue siendo una de las principales causas de muerte prevenible en todo el mundo.
- Las farmacoterapias efectivas de primera línea son cruciales para dejar de fumar.
- La terapia de reemplazo de nicotina (TRN), el bupropión y la vareniclina son tratamientos establecidos.
Objetivo del estudio:
- Para comparar la eficacia de la NRT, el bupropión y la vareniclina para la abstinencia de fumar a largo plazo.
- Evaluar los eventos adversos graves asociados con estas ayudas de primera línea para dejar de fumar.
Principales métodos:
- Revisión sistemática y metanálisis de ensayos controlados aleatorios.
- La inclusión de estudios que evalúan la terapia de reemplazo de nicotina (TRN), el bupropión y la vareniclina.
- Evaluación de las tasas de abandono del tabaquismo a los 6 meses o más y la incidencia de eventos adversos graves.
Principales resultados:
- La NRT (17,6%) y el bupropión (19,1%) demostraron tasas de cesación más altas en comparación con el placebo (10,6%).
- La vareniclina (27,6%) y la combinación de NRT (31,5%) mostraron la mayor eficacia para lograr el abandono del tabaquismo.
- No se observó un aumento significativo en los eventos adversos graves para ninguno de los tratamientos activos en comparación con el placebo.
Conclusiones:
- La vareniclina y la NRT combinada son las farmacoterapias de primera línea más efectivas para dejar de fumar.
- Todos los tratamientos evaluados, incluidos NRT, bupropión y vareniclina, son seguros en cuanto a eventos adversos graves.
- Estos hallazgos apoyan el uso de vareniclina y la combinación de NRT para las personas que buscan dejar de fumar.
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