酒精依赖吸烟者给予伐尼克兰治疗烟草依赖
2018/03/19
背景：酗酒和酒精依赖者中吸烟者众多。伐尼克兰是有效的戒烟药物，并可以减少饮酒量。本研究目的旨在评估12周伐尼克兰治疗对于提高酗酒者或酒精依赖者戒烟率的作用。
方法：大于18岁，每天吸烟大于10支，持续超过6个月的当前酗酒或酒精依赖者，自愿戒烟。受试者随机分入接受12周伐尼克兰（1mg 每天2次）或安慰剂治疗。首要研究终点为12周的7天时点戒烟率。
结果：12周7天时点戒烟率，伐尼克兰组（n=16）明显优于安慰剂组(n=17)(43.8% vs5.9%; p=0.01)。24周，伐尼克兰组仍显著高于安慰剂组（31.3% vs0%; p=0.02）。第12周，伐尼克兰组平均每日饮酒量（SD）低于安慰剂组（5.7 [3.9] vs 9.0 [5.3]疗效预计值：-2.8 [90% CI, -6.6 to -1.0]）。与既往伐尼克兰临床研究相比，药物副作用发生较少且情况相似。
结论：伐尼克兰可以安全有效提高酗酒者或酒精依赖者吸烟者的戒断率，还可以降低戒烟者的饮酒量。
（上海交通大学医学院附属瑞金医院呼吸与危重症医学科 周剑平 万欢英 摘译）
（Drug Alcohol Depend. 2018 Jan 2;184:12-17.）
Varenicline for tobacco-dependence treatment in alcohol-dependent smokers: A randomized controlled trial.
Hurt RT et al.
Abstract
BACKGROUND:Tobacco use is prevalent among persons with alcohol abuse and dependence. Varenicline has been shown to be the most effective pharmacotherapy for smoking cessation and may decrease alcohol consumption. The purpose of this study was to evaluate the efficacy of 12 weeks of varenicline for increasing smoking abstinence rates in smokers with alcohol abuse or dependence.
METHODS:Participants were eligible for enrollment if they were 18 years or older, smoked 10 or more cigarettes per day for at least 6 months, had current alcohol abuse or dependence, and were interested in quitting smoking. Participants were randomly assigned to receive 12 weeks of varenicline 1 mg twice daily or matching placebo. The primary end point was 7-day point prevalence smoking abstinence at week 12.
RESULTS:The 7-day point prevalence smoking abstinence rate at 12 weeks was significantly higher with varenicline (n = 16) than placebo (n = 17) (43.8% vs 5.9%; P = .01). At 24 weeks, the 7-day point prevalence smoking abstinence rate was still significantly higher with varenicline than placebo (31.3% vs 0%; P = .02). At 12 weeks, mean (SD) drinks per drinking day was significantly lower with varenicline than placebo (5.7 [3.9] vs 9.0 [5.3] drinks; treatment effect estimate, -2.8 [90% CI, -6.6 to -1.0]). Adverse events were minor and comparable to varenicline clinical trials.
CONCLUSIONS:Varenicline is safe and efficacious for increasing smoking abstinence rates in smokers with alcohol abuse or dependence. Varenicline may decrease alcohol consumption in this population of smokers.
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