大麻素1型受体拮抗剂(利莫那班)戒烟。

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卡希尔K,阿瑟

大麻素1型受体拮抗剂(利莫那班)戒烟。

科克伦数据库系统启2007年10月17日;(4):CD005353。

PubMed ID
17943852 (在PubMed
]
文摘

背景:利莫那班是一个选择性1型大麻素CB1受体拮抗剂。它可能帮助戒烟通过恢复神经系统的平衡,可以长期使用尼古丁而中断。利莫那班还寻求解决许多吸烟者不愿坚持戒烟尝试因为担心体重增加。目的:确定选择性CB1受体拮抗剂增加人戒烟。评估其对体重变化的影响成功的戒烟者和那些试图戒烟,但失败了。必威国际app搜索策略:我们搜查了Cochrane烟草成瘾审查小组专门注册试验,使用术语“利莫那班”和“吸烟”的标题或抽象,或作为关键字。我们还搜查了ME必威国际appDLINE和EMBASE, CINAHL PsycINFO,主要使用网格。我们获得的电子或纸质副本的海报提出初步试验结果在2005年的美国胸腔学会会议上,和在社会研究尼古丁和烟草欧洲会议2006。必威国际app我们也试图联系作者正在进行的研究的利莫那班,和赛诺菲-安万特(制造商利莫那班)。选择标准:类型的研究:随机对照试验。 TYPES OF PARTICIPANTS: Adult smokers. Types of interventions: Selective CB1 receptor antagonists, such as rimonabant. Types of outcome measures: The primary outcome is smoking status at a minimum of six months after the start of treatment. We preferred sustained cessation rates to point prevalence, and biochemically verified cessation to self-reported quitting. We regarded smokers who drop out or are lost to follow up as continuing smokers. We have noted any adverse effects of treatment.A secondary outcome is weight change associated with the cessation attempt. DATA COLLECTION AND ANALYSIS: Two authors checked the abstracts for relevance, and attempted to acquire full trial reports. One author extracted the data, and a second author checked them. MAIN RESULTS: We found three trials which met our inclusion criteria, covering 1567 smokers (cessation: STRATUS-EU and STRATUS-US), and 1661 quitters (relapse prevention: STRATUS-WW). At one year, the pooled odds ratio (OR) for quitting with rimonabant 20 mg was 1.61 (95% confidence interval (CI) 1.12 to 2.30). No significant benefit was demonstrated for rimonabant at 5 mg dosage. Adverse events included nausea and upper respiratory tract infections. In the relapse prevention trial, smokers who had quit on the 20 mg regimen were 1(1/2) times more likely to remain abstinent on either active regimen than on placebo; the OR for the 20 mg maintenance group was 1.49 (95% CI 1.09 to 2.04, and for the 5 mg maintenance group 1.51 (95% CI 1.11 to 2.07). There appeared to be no significant benefit of maintenance treatment for the 5 mg quitters. Weight gain was reported to be significantly lower among the 20 mg quitters than in the 5 mg or placebo quitters. During treatment, overweight or obese smokers tended to lose weight, while normal weight smokers did not. AUTHORS' CONCLUSIONS: From the preliminary trial reports available, rimonabant 20 mg may increase the odds of quitting approximately 1(1/2)-fold. Adverse events include nausea and upper respiratory tract infections; the risk of serious adverse events is reported to be low. However, there is current concern (August 2007) over rates of depression and suicidal thoughts in people taking rimonabant for weight control. The evidence for rimonabant in maintaining abstinence is inconclusive. Rimonabant 20 mg may moderate weight gain in the long term.

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