不同种类戒烟药物戒烟效果的网状荟萃分析
Efficacy of different kinds of smoking cessation drugs for smoking cessation: Network Meta-analysis
摘要目的:应用网状荟萃分析的方法系统评价不同种类戒烟药物的戒烟效果。方法:计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国生物医学文献数据库、知网、维普网、万方数据库,检索时限为建库至2022年11月,收集安非他酮、伐尼克兰、尼古丁替代疗法(NRT)对比安慰剂对吸烟患者戒断疗效的随机对照试验(RCT)。对符合纳入标准的文献进行资料提取,采用Cochrane风险偏倚工具进行质量评价后,采用Stata15.1统计软件进行网状荟萃分析。结果:共纳入19项RCT研究,合计6 106例患者,涉及3种干预措施(安非他酮、伐尼克兰、NRT)和1种对照措施(安慰剂)。网状荟萃分析结果显示,短期戒断率方面,伐尼克兰( OR=4.21,95% CI:2.32~7.63)、安非他酮( OR=2.81,95% CI:1.05~7.54)均优于安慰剂( P<0.05)。累积排序区域下面积(SUCRA):伐尼克兰(90.2%)>安非他酮(64.8%)>NRT(41.7%)>安慰剂(3.2%)。长期戒断率方面,伐尼克兰( OR=3.06,95% CI:1.59~5.90)、NRT( OR=3.39,95% CI:2.20~5.21)优于安慰剂( P<0.05)。SUCRA:伐尼克兰(83.8%)>NRT(73.9%)>安非他酮(37.2%)>安慰剂(5.2%)。 结论:网状荟萃分析结果表明,相较于安非他酮和NRT,伐尼克兰具有较好的戒烟效果。
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abstractsObjective:To systematically evaluate the efficacy of different kinds of smoking cessation drugs by network Meta-analysis.Methods:Literature was retrieved from PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, VIP, Wan fang database, from the establishment of the database to November 2022, and randomized controlled trials (RCT) about bupropion, varenicline, nicotine replacement therapy (NRT) versus placebo in the treatment of smoking patients were collected. After data extraction from included literature which met inclusion criteria, and quality evaluation with Cochrane 5.1 risk bias evaluation tool, network Meta-analysis was performed by Stata15.1 software.Results:A total of 19 RCTs, involving 6106 patients and three interventions measures (bupropion, varenicline, NRT) and one control measure (placebo) were included. The results of network Meta-analysis showed that in terms of short-term abstinence rate, varenicline [ OR=4.21, 95% CI (2.32, 7.63)], bupropion [ OR=2.81, 95% CI(1.05, 7.54)] were better than placebo ( P<0.05). The surface under the cumulative ranking area (SUCRA): varenicline (90.2%)>bupropion (64.8%)>NRT (41.7%)>placebo (3.2%). In terms of the long-term abstinence rate, varenicline [ OR=3.06, 95% CI (1.59, 5.90)], NRT [ OR=3.39, 95% CI (2.20, 5.21)] were better than placebo ( P<0.05). SUCRA: varenicline (83.8%)>NRT (73.9%)>bupropion (37.2%)>placebo (5.2%). Conclusion:The existing evidence shows that compared with bupropion, NRT, varenicline has the best effect on quitting smoking, but more high-quality randomized trial evidence is needed for verification.
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