在初始治疗失败后戒烟:随机临床试验
Paul M Cinciripini1, Charles E Green2, Sanjay Shete1
1Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston.
JAMA
|May 2, 2024
概括
对于没有戒烟的吸烟者来说,增加瓦雷尼克林剂量可以促进戒烟. 在结合尼古丁替代疗法 (CNRT) 后切换为瓦雷尼克林或增加剂量也有助于戒烟.
科学领域:
- 药物成
- 临床药理学
- 公共卫生
背景情况:
- 大多数吸烟者在第一次尝试时都无法戒烟.
- 对非戒烟者而言,需要有效的二线戒烟策略.
研究的目的:
- 确定吸烟者在初始治疗瓦雷尼克林或联合尼古丁替代疗法 (CNRT) 后未能实现戒烟的最佳后续治疗策略.
主要方法:
- 一个双盲,安慰剂控制,连续多重分配的随机试验,涉及490名志愿者.
- 参与者接受了6周的瓦伦尼克林或CNRT治疗,非戒断者被随机重新安排继续,更换或增加药物剂量6周.
- 生物化学验证的7天禁食率在12周后是主要结果.
主要成果:
- 对于没有服用瓦伦尼克林的人来说,增加剂量导致20%的戒断率,明显高于继续服用初始剂量 (3%).
- 对于没有戒断的CNRT患者,与继续使用初始CNRT (8%) 相比,转换为瓦雷尼克林 (14%戒断) 或增加CNRT剂量有所改善.
- 增加瓦伦尼克林和CNRT的剂量显示在连续6个月的戒断期间有好处.
结论:
- 对于未能实现戒烟的吸烟者,增加剂量是有效的救助策略.
- 对于未能达到最初戒烟的吸烟者来说,转换为瓦雷尼克林或增加CNRT剂量是可行的救援策略.
- 这些发现提供了有价值的见解, 以适应患者个体需求的戒烟治疗方法.
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