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Auteur Kate Cahill |
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Titre : Nicotine receptor partial agonists for smoking cessation (review) Type de document : texte imprimé Auteurs : Kate Cahill, Auteur ; Lindsay F. Stead, Auteur ; T. Lancaster, Auteur Editeur : The Cochrane Collaboration Année de publication : 2008 Collection : Cochrane Database of Systematic Reviews Importance : 60 p. Langues : Français (fre) Catégories : [TABAC] chimie du tabac:constituant:alcaloïde:nicotine:récepteur nicotinique
[TABAC] étude
[TABAC] sevrage tabagique:méthode de sevrage:méthode individuelle:approche pharmacologique:varéniclineIndex. décimale : TA 6.2.3.1.4 Autres substituts nicotiniques Résumé : Nicotine receptor partial agonists may help people to stop smoking by a combination of maintaining moderate levels of dopamine to
counteract withdrawal symptoms (acting as an agonist) and reducing smoking satisfaction (acting as an antagonist). Varenicline was
developed as a nicotine receptor partial agonist from cytisine, a drug widely used in central and eastern Europe for smoking cessation.
The first trial reports of varenicline were released in 2006, and further trials have now been published or are currently are underway.En ligne : https://doi.org/10.1002/14651858.CD006103.pub8 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=7881 Exemplaires (1)
Code-barres Cote Support Localisation Section Disponibilité TA 002133 TA 6.2.3.1.4 CAH N Article/Périodique Bibliothèque FARES Tabac Consultation sur place
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Titre : Pharmacological interventions for smoking cessation : an overview and network meta-analysis (review) Type de document : texte imprimé Auteurs : Kate Cahill, Auteur ; S. Stevens, Auteur ; T. Lancaster, Auteur ; R. Perera, Auteur Editeur : The Cochrane Collaboration Année de publication : 2013 Collection : Cochrane Database of Systematic Reviews num. issue 5 Importance : 49 p. Langues : Français (fre) Catégories : [TABAC] étude:méta-analyse
[TABAC] sevrage tabagique:méthode de sevrage:méthode individuelle:approche pharmacologiqueIndex. décimale : TA 6.2.3 Approche pharmacologique Résumé : Abstract
Background
Smoking is the leading preventable cause of illness and premature death worldwide. Some medications have been proven to help people to quit, with three licensed for this purpose in Europe and the USA: nicotine replacement therapy (NRT), bupropion, and varenicline. Cytisine (a treatment pharmacologically similar to varenicline) is also licensed for use in Russia and some of the former socialist economy countries. Other therapies, including nortriptyline, have also been tested for effectiveness.
Objectives
How do NRT, bupropion and varenicline compare with placebo and with each other in achieving long-term abstinence (six months or longer)?
How do the remaining treatments compare with placebo in achieving long-term abstinence?
How do the risks of adverse and serious adverse events (SAEs) compare between the treatments, and are there instances where the harms may outweigh the benefits?
Methods
The overview is restricted to Cochrane reviews, all of which include randomised trials. Participants are usually adult smokers, but we exclude reviews of smoking cessation for pregnant women and in particular disease groups or specific settings. We cover nicotine replacement therapy (NRT), antidepressants (bupropion and nortriptyline), nicotine receptor partial agonists (varenicline and cytisine), anxiolytics, selective type 1 cannabinoid receptor antagonists (rimonabant), clonidine, lobeline, dianicline, mecamylamine, Nicobrevin, opioid antagonists, nicotine vaccines, and silver acetate. Our outcome for benefit is continuous or prolonged abstinence at least six months from the start of treatment. Our outcome for harms is the incidence of serious adverse events associated with each of the treatments.
We searched the Cochrane Database of Systematic Reviews (CDSR) in The Cochrane Library, for any reviews with 'smoking' in the title, abstract or keyword fields. The last search was conducted in November 2012. We assessed methodological quality using a revised version of the AMSTAR scale. For NRT, bupropion and varenicline we conducted network meta-analyses, comparing each with the others and with placebo for benefit, and varenicline and bupropion for risks of serious adverse events.
Main results
We identified 12 treatment-specific reviews. The analyses covered 267 studies, involving 101,804 participants. Both NRT and bupropion were superior to placebo (odds ratios (OR) 1.84; 95% credible interval (CredI) 1.71 to 1.99, and 1.82; 95% CredI 1.60 to 2.06 respectively). Varenicline increased the odds of quitting compared with placebo (OR 2.88; 95% CredI 2.40 to 3.47). Head-to-head comparisons between bupropion and NRT showed equal efficacy (OR 0.99; 95% CredI 0.86 to 1.13). Varenicline was superior to single forms of NRT (OR 1.57; 95% CredI 1.29 to 1.91), and to bupropion (OR 1.59; 95% CredI 1.29 to 1.96).
Varenicline was more effective than nicotine patch (OR 1.51; 95% CredI 1.22 to 1.87), than nicotine gum (OR 1.72; 95% CredI 1.38 to 2.13), and than 'other' NRT (inhaler, spray, tablets, lozenges; OR 1.42; 95% CredI 1.12 to 1.79), but was not more effective than combination NRT (OR 1.06; 95% CredI 0.75 to 1.48). Combination NRT also outperformed single formulations. The four categories of NRT performed similarly against each other, apart from 'other' NRT, which was marginally more effective than NRT gum (OR 1.21; 95% CredI 1.01 to 1.46).
Cytisine (a nicotine receptor partial agonist) returned positive findings (risk ratio (RR) 3.98; 95% CI 2.01 to 7.87), without significant adverse events or SAEs.
Across the 82 included and excluded bupropion trials, our estimate of six seizures in the bupropion arms versus none in the placebo arms was lower than the expected rate (1:1000), at about 1:1500. SAE meta-analysis of the bupropion studies demonstrated no excess of neuropsychiatric (RR 0.88; 95% CI 0.31 to 2.50) or cardiovascular events (RR 0.77; 95% CI 0.37 to 1.59). SAE meta-analysis of 14 varenicline trials found no difference between the varenicline and placebo arms (RR 1.06; 95% CI 0.72 to 1.55), and subgroup analyses detected no significant excess of neuropsychiatric events (RR 0.53; 95% CI 0.17 to 1.67), or of cardiac events (RR 1.26; 95% CI 0.62 to 2.56).
Nortriptyline increased the chances of quitting (RR 2.03; 95% CI 1.48 to 2.78). Neither nortriptyline nor bupropion were shown to enhance the effect of NRT compared with NRT alone. Clonidine increased the chances of quitting (RR 1.63; 95% CI 1.22 to 2.18), but this was offset by a dose-dependent rise in adverse events. Mecamylamine in combination with NRT may increase the chances of quitting, but the current evidence is inconclusive. Other treatments failed to demonstrate a benefit compared with placebo. Nicotine vaccines are not yet licensed for use as an aid to smoking cessation or relapse prevention. Nicobrevin's UK license is now revoked, and the manufacturers of rimonabant, taranabant and dianicline are no longer supporting the development or testing of these treatments.
Authors' conclusions
NRT, bupropion, varenicline and cytisine have been shown to improve the chances of quitting. Combination NRT and varenicline are equally effective as quitting aids. Nortriptyline also improves the chances of quitting. On current evidence, none of the treatments appear to have an incidence of adverse events that would mitigate their use.
Further research is warranted into the safety of varenicline and into cytisine's potential as an effective and affordable treatment, but not into the efficacy and safety of NRT.En ligne : https://doi.org/10.1002/14651858.CD009329.pub2 Format de la ressource électronique : HTML, PDF Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=7444 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Quit and win contests for smoking cessation Type de document : texte imprimé Auteurs : Kate Cahill, Auteur Editeur : Wiley Année de publication : 2008 Importance : 72 p. Présentation : tab. graph. Format : a4 Langues : Français (fre) Catégories : [TABAC] sevrage tabagique Index. décimale : TA 6.1 Généralités Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=3139 Exemplaires (1)
Code-barres Cote Support Localisation Section Disponibilité TA 005064 TA 6.1 CAH Q Rapport Bibliothèque FARES Tabac Disponible Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Stage-based interventions for smoking cessation Type de document : texte imprimé Auteurs : Kate Cahill, Auteur ; T. Lancaster, Auteur ; Natasha Green, Auteur Editeur : The Cochrane Collaboration Année de publication : 2010 Collection : Cochrane Database of Systematic Reviews num. 11 Importance : 3 p. Langues : Anglais (eng) Catégories : [TABAC] étude
[TABAC] sevrage tabagique:méthode de sevrage:méthode individuelle:approche psychologique:entretien motivationnel:modèle transthéoriqueIndex. décimale : TA 6.2.2.1 Méthode comportementale Résumé : BACKGROUND:
The transtheoretical model is the most widely known of several stage-based theories of behaviour. It proposes that smokers move through a discrete series of motivational stages before they quit successfully. These are precontemplation (no thoughts of quitting), contemplation (thinking about quitting), preparation (planning to quit in the next 30 days), action (quitting successfully for up to six months), and maintenance (no smoking for more than six months). According to this influential model, interventions which help people to stop smoking should be tailored to their stage of readiness to quit, and are designed to move them forward through subsequent stages to eventual success. People in the preparation and action stages of quitting would require different types of support from those in precontemplation or contemplation.
OBJECTIVES:
Our primary objective was to test the effectiveness of stage-based interventions in helping smokers to quit.
SEARCH STRATEGY:
We searched the Cochrane Tobacco Addiction Group's specialised register for trials, using the terms ('stage* of change', 'transtheoretical model*', 'trans-theoretical model*, 'precaution adoption model*', 'health action model', 'processes of change questionnaire*', 'readiness to change', 'tailor*') and 'smoking' in the title or abstract, or as keywords. The latest search was in August 2010.
SELECTION CRITERIA:
We included randomized controlled trials, which compared stage-based interventions with non-stage-based controls, with 'usual care' or with assessment only. We excluded trials which did not report a minimum follow-up period of six months from start of treatment, and those which measured stage of change but did not modify their intervention in the light of it.
DATA COLLECTION AND ANALYSIS:
We extracted data in duplicate on the participants, the dose and duration of intervention, the outcome measures, the randomization procedure, concealment of allocation, and completeness of follow up.The main outcome was abstinence from smoking for at least six months. We used the most rigorous definition of abstinence, and preferred biochemically validated rates where reported. Where appropriate we performed meta-analysis to estimate a pooled risk ratio, using the Mantel-Haenszel fixed-effect model.
MAIN RESULTS:
We found 41 trials (>33,000 participants) which met our inclusion criteria. Four trials, which directly compared the same intervention in stage-based and standard versions, found no clear advantage for the staging component. Stage-based versus standard self-help materials (two trials) gave a relative risk (RR) of 0.93 (95% CI 0.62 to 1.39). Stage-based versus standard counselling (two trials) gave a relative risk of 1.00 (95% CI 0.82 to 1.22). Six trials of stage-based self-help systems versus any standard self-help support demonstrated a benefit for the staged groups, with an RR of 1.27 (95% CI 1.01 to 1.59). Twelve trials comparing stage-based self help with 'usual care' or assessment-only gave an RR of 1.32 (95% CI 1.17 to 1.48). Thirteen trials of stage-based individual counselling versus any control condition gave an RR of 1.24 (95% CI 1.08 to 1.42). These findings are consistent with the proven effectiveness of these interventions in their non-stage-based versions. The evidence was unclear for telephone counselling, interactive computer programmes or training of doctors or lay supporters. This uncertainty may be due in part to smaller numbers of trials.
AUTHORS' CONCLUSIONS:
Based on four trials using direct comparisons, stage-based self-help interventions (expert systems and/or tailored materials) and individual counselling were neither more nor less effective than their non-stage-based equivalents. Thirty-one trials of stage-based self help or counselling interventions versus any control condition demonstrated levels of effectiveness which were comparable with their non-stage-based counterparts. Providing these forms of practical support to those trying to quit appears to be more productive than not intervening. However, the additional value of adapting the intervention to the smoker's stage of change is uncertain. The evidence is not clear for other types of staged intervention, including telephone counselling, interactive computer programmes and training of physicians or lay supporters. The evidence does not support the restriction of quitting advice and encouragement only to those smokers perceived to be in the preparation and action stages.En ligne : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004492.pub4/full Format de la ressource électronique : Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=8079 Exemplaires (1)
Code-barres Cote Support Localisation Section Disponibilité TA 005631 TA 6.2.2.1 CAH S Article/Périodique Bibliothèque FARES Tabac Consultation sur place
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