2型糖尿病患者戒烟的药物干预：荟萃分析和GRADE评价的系统综述

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-04-26 DOI:10.1016/j.diabres.2025.112202

Alison Martin , Giusy Rita Maria La Rosa , Hannah Rice , Andrea Bertuzzi , Michal Witkowski , Erika Anastasi , Giulio Geraci , Riccardo Polosa , the DiaSmokeFree Working Group

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引用次数: 0

摘要

目的通过系统回顾、荟萃分析和GRADE评价2型糖尿病（T2DM）患者戒烟的药物治疗的有效性和安全性。方法于2024年6月7日使用相关关键词检索spubmed和Scopus。随机对照试验和前瞻性队列研究纳入了接受药物治疗戒烟的成年2型糖尿病吸烟者。数据由两位审稿人独立提取。进行随机效应荟萃分析，并使用GRADE评估证据的确定性。结果共纳入18篇研究，19篇文献。药物治疗显著提高了12周和24周的持续戒断率(p <；0.001)， or分别为4.17 （95% CI: 2.71-6.42）和3.80 （95% CI: 2.52-5.72）。在52周时，伐尼克兰比安慰剂更有效（OR: 2.84, 95% CI: 1.41-5.69, p = 0.003）。伐尼克兰组的不良事件发生率更高，但差异无统计学意义（OR: 1.40, 95% CI: 0.98-1.98, p = 0.06）。结论：伐尼克兰对T2DM患者戒烟有效，且耐受性可接受。安非他酮和NRT显示出潜在的疗效。然而，大多数证据来自事后分析，其中糖尿病不是预先定义的变量，需要谨慎解释。

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Pharmacological interventions for smoking cessation in Type 2 diabetes: A systematic review with meta-analysis and GRADE evaluation

Aims

To evaluate the efficacy and safety of pharmacological therapies for smoking cessation in individuals with Type 2 Diabetes Mellitus (T2DM) through a systematic review, meta-analysis, and GRADE evaluation.

Methods

PubMed and Scopus were searched on 7 June 2024 using relevant keywords. Randomized controlled trials and prospective cohort studies involving adult smokers with T2DM receiving pharmacological treatments for smoking cessation were included. Data were extracted independently by two reviewers. Random-effects meta-analyses were conducted, and the certainty of evidence was assessed using GRADE.

Results

Eighteen studies (19 publications) were included. Pharmacotherapy significantly increased continuous abstinence rates at 12 and 24 weeks (p < 0.001), with ORs of 4.17 (95 % CI: 2.71–6.42) and 3.80 (95 % CI: 2.52–5.72), respectively. At 52 weeks, varenicline was more effective than placebo (OR: 2.84, 95 % CI: 1.41–5.69, p = 0.003). Adverse events were more frequent with varenicline, but not significantly (OR: 1.40, 95 % CI: 0.98–1.98, p = 0.06).

Conclusions

Varenicline appears effective for smoking cessation in T2DM, with an acceptable tolerability profile. Bupropion and NRT show potential efficacy. However, most evidence comes from post hoc analyses in which diabetes was not a predefined variable, warranting cautious interpretation.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.