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Combination Pharmacological Interventions for Smoking Cessation and Post-Cessation Weight Gain: A Meta-Analysis of Randomized Controlled Trials

대한작업치료학회지 2020년 28권 4호 p.121 ~ 135
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Abstract


Objective: Limited evidence exists concerning whether combined pharmacotherapy is more effective thanmonotherapy for increased smoking abstinence and post-cessation weight gain prevention. This researchinvestigated the effect of combined pharmacotherapy on smoking abstinence and post-cessation weight change.

Methods: A meta-analytic review of Randomized Controlled Trials (RCTs) published between January 1990 andJuly 2016 was conducted across PubMed, International Pharmaceutical Abstracts, Web of Science, and CochraneLibrary. Aggregate fixed effects were estimated for continuous abstinence and mean post-cessation weightchange. Keyword search terms included: “smoking cessation,” “naltrexone”, “varenicline”, and “bupropion”.

Results: Eight RCTs with 2,513 participants were included. Aggregate fixed effect estimates revealed an increasein continuous smoking abstinence (OR = 1.81, p < .001) and mean decrease in post-cessation weight change(-.15 kg, p = .001). Decreased weight change was observed at 6-8 weeks follow-up (-.14 kg, p = .02).
Increased mean weight change was observed among varenicline plus nicotine patch abstainers (.21 kg, p = .01),whereas bupropion plus NRT pharmacotherapies showed decreased mean weight change (-.15 kg, p = .01).

Conclusion: Combination pharmacotherapy generates increased smoking abstinence and small short-termpost-cessation weight change among abstainers, particularly among bupropion plus NRT when compared againstvarenicline plus nicotine patch.

키워드

Bupropion; Combination; Meta-analysis; Nicotine replacement therapy; Pharmacotherapy; Post-cessation smoking cessation; Varenicline; Weight gain

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