Smoking cessation: benefits versus risks of using pharmacotherapy to quit.

Smoking cessation: benefits versus risks of using pharmacotherapy to quit.
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戒烟:使用药物疗法戒烟的益处与风险。

DOI:
10.1161/circulationaha.113.006928
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发表时间:
2014
期刊:
影响因子:
37.8
通讯作者:
Samet,JonathanM
Samet,JonathanM
中科院分区:
医学1区
文献类型:
--
作者:
Samet,JonathanM

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收缩冠状动脉它也可能导致内皮功能障碍和代谢异常。预计这些影响不会超过NRT治疗期。在纳入系统性综述的试验中,大多数试验的治疗持续时间仅为几个月,只有2项试验涉及尼古丁给药> 52周。因此,基于对尼古丁药理学作用的理解,无法轻易解释NRT停用后风险大幅增加的原因。与安非他酮相关的主要不良心血管事件风险降低的发现也不能简单地解释为生物相容性,该发现是否可能是分析方法的人为因素?网络荟萃分析会得出基于1个代理与另一个代理的直接比较和间接比较的推论。[14]米尔斯及其同事审查的证据仅包括3种药物之间的6项直接比较,作者未提供直接和间接证据的比较,例如一致性。考虑到稀疏的结果数据,敏感性分析的进一步探索可能会为推动NRT关键发现的研究提供信息。
constricts coronary arteries. It may also contribute to endothelial dysfunction and metabolic abnormalities. Such effects would not be anticipated to extend beyond the period of NRT therapy. In the trials included in the systematic review, therapy was only of a few months duration in most trials, and only 2 trials involved nicotine administration of> 52 weeks. Thus, the increase in risk substantially after NRT was discontinued cannot be readily explained based on an understanding of nicotine’s pharmacological effects. The finding of decreased risk for major adverse cardiovascular events associated with bupropion also cannot be readily interpreted as to biological plausibility.Could the findings be an artifact of the analytical method? A network meta-analysis leads to inferences that are based on both direct comparisons of 1 agent with another agent and on indirect comparisons. 14 The evidence reviewed by Mills and colleagues includes only 6 direct comparisons among the 3 agents, and a comparison of the direct and indirect evidence, eg, the coherence, is not provided by the authors. Given the sparse outcome data, further probing with sensitivity analysis might be informative as to the studies that are driving the key findings for NRT.
DOI: 10.1001/jama.1990.03450150028009
发表时间: 1990
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