Сетевой метаанализ: сравнение эффективности и безопасности частичных агонистов никотиновых ацетилхолиновых рецепторов варениклина и цитизина для лечения никотиновой зависимости
- Авторы: Радченко Е.В.1, Суховская О.А.2, Галанкин Т.Л.1, Колбин А.С.1, Смирнова М.А.2
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Учреждения:
- ФГБОУ ВО «Первый Санкт-Петербургский медицинский университет им. академика И.П. Павлова» Минздрава России
- ФГБУ «Санкт-Петербургский НИИ фтизиопульмонологии» Минздрава России
- Выпуск: Том 16, № 4 (2018)
- Страницы: 19-32
- Раздел: Статьи
- URL: https://journals.rcsi.science/RCF/article/view/11084
- DOI: https://doi.org/10.17816/RCF16419-32
- ID: 11084
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Аннотация
Цель работы — провести сравнение эффективности и безопасности частичных агонистов никотиновых ацетилхолиновых рецепторов варениклина и цитизина.
Методы. Поиск рандомизированных клинических исследований в базах данных MEDLINE, EMBASE, eLibrary. Оценивали характеристики участников исследования, дозировку, продолжительность лечения, наличие/отсутствие рандомизации, потерю зрения, основные точки эффективности, безопасность. Выполнен иерархический байесовский сетевой метаанализ.
Результаты.Цитизин значимо превосходил плацебо на 12, 24 и 52-й неделе терапии. Отношение шансов (ОШ) составило соответственно 3,3 (95 % доверительный интервал (ДИ) 1,8–5,8), 3,9 (2,4–6,7), 3,8 (1,3–11,9). Варениклин в дозе 2 мг/сут также значимо превосходил эффекты плацебо на 12, 24 и 52-й неделе терапии. ОШ составило соответственно 4,0 (3,3–4,7), 3,1 (2,5–3,7), 2,9 (2,2–4,1). Варениклин в дозе 1 мг/сут значимо превосходил эффекты плацебо на 12-й и 52-й неделе терапии, ОШ составило соответственно 3,0 (2,0–4,7) и 2.3 (1,3–4,4). Варениклин в дозе 0,5 мг/сут значимо превосходил эффекты плацебо на 12-й неделе терапии, ОШ составило 2,4 (1,2–4,8). Цитизин и варениклин имели более высокий риск развития нежелательных побочных явлений со стороны желудочно-кишечного тракта по сравнению с плацебо: ОШ для цитизина составило 6,2 (2,1–22,8), варениклина — 2 мг/сут 2,4 (2,0–2,8). Цитизин и варениклин имели более высокие шансы психических нарушений по сравнению с плацебо: ОШ для цитизина — 5,2 (1,9–15,1), варениклина 2 мг/сут — 1,6 (1,3–1,9). Частота серьезных нежелательных явлений у варениклина и цитизина была сравнима с плацебо: ОШ для цитизина — 2,4 (0,8–6,8), варениклина 2 мг/сут — 2,0 (0,5–6,6), варениклина 1 мг/сут — 1,0 (0,3–2,7), варениклина 0,5 мг/сут — 1,0 (0,7–1,4).
Заключение. Цитизин имеет сходный с варениклином профиль эффективности и безопасности при лечении никотиновой зависимости.
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Елена Владимировна Радченко
ФГБОУ ВО «Первый Санкт-Петербургский медицинский университет им. академика И.П. Павлова» Минздрава России
Автор, ответственный за переписку.
Email: lena.radchenko@gmail.com
аспирант, кафедра клинической фармакологии и доказательной медицины
Россия, Санкт-ПетербургОльга Анатольевна Суховская
ФГБУ «Санкт-Петербургский НИИ фтизиопульмонологии» Минздрава России
Email: ktc01@mail.ru
д-р биол. наук, руководитель центра
Россия, Санкт-ПетербургТимофей Леонидович Галанкин
ФГБОУ ВО «Первый Санкт-Петербургский медицинский университет им. академика И.П. Павлова» Минздрава России
Email: galankint@gmail.com
канд. мед. наук, зав. лабораторией фармакоэпидемиологии и фармакокинетики
Россия, Санкт-ПетербургАлексей Сергеевич Колбин
ФГБОУ ВО «Первый Санкт-Петербургский медицинский университет им. академика И.П. Павлова» Минздрава России
Email: alex.kolbin1971@gmail.com
заведующий кафедрой клинической фармакологии и доказательной медицины
Россия, Санкт-ПетербургМария Александровна Смирнова
ФГБУ «Санкт-Петербургский НИИ фтизиопульмонологии» Минздрава России
Email: ktcniif@mail.ru
врач-терапевт
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