为住院吸烟者提供瓦伦尼克林和尼古丁替代疗法:一项随机临床试验
Gregory R Weeks1,2, Rukshar K Gobarani1, Michael J Abramson3
1Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.
JAMA network open
|June 27, 2024
概括
将瓦雷尼克林与尼古丁替代疗法 (NRT) 药片相结合,改善了住院患者自我报告的吸烟戒断. 然而,生物化学验证的戒断率与组合疗法并没有显著增加.
科学领域:
- 临床医学 临床医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 瓦伦尼克林是一种非常有效的单一疗法,用于戒烟.
- 将瓦雷尼克林与尼古丁替代疗法 (NRT) 结合使用可能会提高戒烟率,但需要严格评估疗效和安全性.
研究的目的:
- 为了确定使用瓦雷尼克林加NRT药片的住院吸烟者是否比单独使用瓦雷尼克林的吸烟者获得更高的长期戒烟率.
- 评估瓦雷尼克林和NRT联合治疗的安全性.
主要方法:
- 这是一项双盲,安慰剂控制的随机临床试验,涉及5家澳大利亚医院的320名成年住院患者.
- 参与者接受了为期12周的瓦伦尼克林治疗方案,并随机分配到NRT (2 mg) 或安慰剂药片以缓解吸烟的冲动.
- 为所有人提供行为支持 (退出线);主要结果是6个月后生物化学验证的持续戒断.
主要成果:
- 在组合 (11.4%) 和单独使用瓦雷尼克林 (10.1%) 组之间,6个月后生物化学验证的戒断没有显著差异 (OR,1.14;95% CI,0.56-2.33).
- 组合疗法显著改善了二次结果,包括7天流行点禁欲在6个月和12个月,以及长期禁欲在12个月.
- 6个月后自我报告的长期戒断有利于组合,但没有统计学意义;不同组的不良事件是相似的.
结论:
- 与瓦雷尼克林和NRT药片的联合治疗改善了住院成年吸烟者的自我报告的戒烟,而没有增加不良事件.
- 尽管自我报告的戒断和一些次要结果有所改善,但与单独使用瓦雷尼克林相比,这种组合并没有显著提高生化验证的戒断.
- 可能需要进一步的研究来澄清组合药物治疗在实现持续,生物化学验证的戒烟方面的作用.
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