Efficacy and safety of pharmacological intervention for smoking cessation in smokers with diseases: A systematic review and network meta-analysis

Xing，Xin1,2,3; Shang，Xue4; Deng，Xinxin1,2,5; Guo，Kangle6; Fenfen，E.1,2,5; Zhou，Liying1,2,5; Wang，Yongsheng1,2,5; Yang，Chaoqun1,2,5; Yang，Kehu1,2; Li，Xiuxia5

2023-12-01

10.1111/jebm.12570

Journal of Evidence-Based Medicine   影响因子和分区

1756-5383

1756-5391

Objective: To investigate the most effective and best-tolerated drugs for treating diseased smokers. Methods: Eight databases were searched for randomized controlled trials (RCTs) involving different pharmacological interventions for smoking cessation in disease patients (January 2023). Network meta-analysis was performed using STATA 15.1 software. The Cochrane Risk of Bias Tool assessed the risk of bias, and confidence in evidence was assessed using CINeMA. Results: A total of 60 RCTs involving 13,009 patients of 12 disease categories were included. All trials reported 13 interventions, resulting in 78 comparisons. Network meta-analysis showed that varenicline (OR = 2.30, 95% CI (1.77, 3.00)) and bupropion (OR = 1.65, 95% CI (1.29, 2.11)) showed favorable abstinence effects compared to placebo in the cardiovascular disease population. Nicotine replacement therapy (NRT) had better withdrawal advantages than placebo (OR = 11.18, 95% CI (2.25, 55.54)) in the chronic obstructive pulmonary disease (COPD) population. Some combination treatments showed better results than monotherapy, such as bupropion + NRT was superior to bupropion (OR = 8.45, 95% CI (1.84, 38.89)) and NRT (OR = 4.98, 95% CI (1.25, 19.78)) in mental illness population. The final surface under the cumulative ranking curve indicated that bupropion + NRT achieved the best smoking cessation effect. Overall confidence in the evidence was low. In a comparison of drugs, the results showed that bupropion + NRT had the best safety. Conclusions: Most interventions show the benefit of quitting smoking compared with placebo, including monotherapy and combination therapy. Moreover, varenicline or bupropion combined with NRT is superior to some monotherapies.

network meta-analysis pharmacotherapy smoking cessation systematic review

SCI

英语

其他

2-s2.0-85179662361

Scopus

1.Evidence-Based Medicine Center,School of Basic Medical Sciences,Lanzhou University,Lanzhou,China
2.Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province,Lanzhou,China
3.School of Public Health,Gansu University Of Chinese Medicine,Lanzhou,China
4.School of Public Health and Emergency Management,Southern University of Science and Technology,Shenzhen,China
5.Health Technology Assessment Center/Evidence-Based Social Science Research Center,School of Public Health,Lanzhou University,Lanzhou,China
6.Department of infection management,Gansu Provincial Hospital,Lanzhou,China

Xing，Xin,Shang，Xue,Deng，Xinxin,et al. Efficacy and safety of pharmacological intervention for smoking cessation in smokers with diseases: A systematic review and network meta-analysis[J]. Journal of Evidence-Based Medicine,2023,16(4):520-533.

Xing，Xin.,Shang，Xue.,Deng，Xinxin.,Guo，Kangle.,Fenfen，E..,...&Li，Xiuxia.(2023).Efficacy and safety of pharmacological intervention for smoking cessation in smokers with diseases: A systematic review and network meta-analysis.Journal of Evidence-Based Medicine,16(4),520-533.

Xing，Xin,et al."Efficacy and safety of pharmacological intervention for smoking cessation in smokers with diseases: A systematic review and network meta-analysis".Journal of Evidence-Based Medicine 16.4(2023):520-533.