An RCT with the combination of varenicline and bupropion for smoking cessation: clinical implications for front line use.
An RCT with the combination of varenicline and bupropion for smoking cessation: clinical implications for front line use.
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DOI：
10.1111/add.14250
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发表时间：
2018-04-21
期刊：
影响因子：
--
通讯作者：
Karam-Hage M
中科院分区：
文献类型：
--
作者：
Cinciripini PM;Minnix JA;Green CE;Robinson JD;Engelmann JM;Versace F;Wetter DW;Shete S;Karam-Hage M
尽管有几种有效的戒烟治疗方法，但只有不到25%的戒烟者在治疗一年后仍能保持戒烟。本研究旨在确定伐尼克兰和安非他酮联合治疗是否会比伐尼克兰单独治疗产生更高的戒断率。一项双盲、随机、平行组戒烟临床试验，参与者接受12周的治疗，并随访12个月。美国德州的医院门诊部，专门从事癌症预防。385名社区吸烟者（56%为男性）每天抽1包烟（平均19.66 cigs/day, sd = 9.45）；平均CO为26.43 ppm (S.D. =13.74)；中度依赖（FTCD = 4.79; sd = 2.07）。吸烟者以3:1（有效：安慰剂）的比例随机分配到12周的治疗中：安慰剂（n=56），伐尼克兰（Var; n=166）和伐尼克兰+安非他酮（组合；n=163）。先验的主要结果：12个月后延长禁欲。次要结局：7天点流行戒断和持续戒断；所有戒断措施在治疗结束和6个月的随访。治疗目的分析：Combo组（n=163）在12个月的长期禁欲方面未能表现出优于Var组（n=166）的优势[优势比(OR) = 0.91, 95%可信区间(CI) = 0.50-1.64]，贝叶斯因子= 0.06支持。Var组[OR = 6.66, 95% CI = 1.61 ~ 59.27]和Combo组[OR = 6.06, 95% CI = 1.45 ~ 54.09]均优于安慰剂组（n=56; Score = 8.38, p< 0.016）。在伐伦克林治疗中加入安非他酮并不会比单独使用伐伦克林增加戒烟率。这一发现支持了先前的研究，即与安慰剂相比，伐尼克兰和伐尼克兰与安非他酮联合使用对戒烟的效果始终良好。
Despite the availability of several efficacious smoking cessation treatments, less than 25% of smokers who quit remain abstinent 1 year post treatment. This study aimed to determine if varenicline and bupropion combination treatment would result in higher abstinence rates than varenicline alone. A double-blind, randomized, parallel groups smoking cessation clinical trial in which participants were exposed to 12 weeks of treatment and followed for 12 months. Hospital-based outpatient clinic in Texas, USA specializing in cancer prevention. 385 community smokers (56% male) who smoked 1 pack cigarettes/day (Mean = 19.66 cigs/day, S.D. = 9.45); had an average CO of 26.43 ppm (S.D. =13.74); and were moderately dependent (FTCD = 4.79; S.D. = 2.07). Smokers were randomized in a 3:1 (Active: Placebo) ratio to 12 weeks of treatment as follows: Placebo (n=56), Varenicline (Var; n=166), and Varenicline + Bupropion (Combo; n=163). A priori primary outcome: Prolonged abstinence at 12 months. Secondary outcomes: Seven-day point prevalence abstinence and continuous abstinence; all abstinence measures at end of treatment and 6 month follow-ups. Intent to treat analysis: the Combo group (n=163) failed to demonstrate superiority to the Var group (n=166) for prolonged abstinence at 12 months [odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.50–1.64], supported by Bayes Factor = 0.06. Both the Var [OR = 6.66, 95% CI = 1.61–59.27] and Combo groups [OR = 6.06, 95% CI = 1.45–54.09] demonstrated superiority to Placebo group (n=56; Score = 8.38, p< 0.016). The addition of bupropion to varenicline treatment does not appear to increase smoking abstinence rates above that of varenicline alone. The findings support previous research showing a consistently favorable effect of both varenicline and the combination of varenicline and bupropion on smoking cessation compared with placebo.
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影响因子：
4.2
作者：
Patterson F;Jepson C;Loughead J;Perkins K;Strasser AA;Siegel S;Frey J;Gur R;Lerman C
通讯作者：
Lerman C
影响因子：
3.4
作者：
Kassel, Jon D.;Yates, Marisa;Brown, Richard A.
通讯作者：
Brown, Richard A.
影响因子：
3.9
作者：
McRae-Clark, Aimee L.;Baker, Nathaniel L.;Norton, Jessica
通讯作者：
Norton, Jessica
影响因子：
1.4
作者：
Cahill, Kate;Stead, Lindsay F.;Polonio, Igor Bastos
通讯作者：
Polonio, Igor Bastos
影响因子：
120.7
作者：
Ebbert, Jon O.;Hatsukami, Dorothy K.;Croghan, Ivana T.;Schroeder, Darrell R.;Allen, Sharon S.;Hays, J. Taylor;Hurt, Richard D.
通讯作者：
Hurt, Richard D.