Combination therapy of varenicline and bupropion in smoking cessation: A meta-analysis of the randomized controlled trials.

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  • Author(s): Zhong Z;Zhong Z; Zhao S; Zhao S; Zhao Y; Zhao Y; Xia S; Xia S
  • Source:
    Comprehensive psychiatry [Compr Psychiatry] 2019 Nov; Vol. 95, pp. 152125. Date of Electronic Publication: 2019 Sep 05.
  • Publication Type:
    Journal Article; Meta-Analysis
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: W.B. Saunders Country of Publication: United States NLM ID: 0372612 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8384 (Electronic) Linking ISSN: 0010440X NLM ISO Abbreviation: Compr Psychiatry Subsets: MEDLINE
    • Publication Information:
      Publication: Philadelphia Pa : W.B. Saunders
      Original Publication: New York.
    • Subject Terms:
      Bupropion/*therapeutic use ; Smoking/*drug therapy ; Smoking Cessation/*methods ; Varenicline/*therapeutic use; Adult ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Nicotinic Agonists/therapeutic use ; Randomized Controlled Trials as Topic ; Smoking Cessation Agents/therapeutic use ; Tobacco Use Disorder/drug therapy
    • Abstract:
      Background: The effects of the combination therapy of varenicline and bupropion in smoking cessation are still controversial.
      Methods: Databases including PubMed, EMBASE, Cochrane Library and Web of Science were scanned without time and language limitation. Subgroup analysis was performed to assess the effect of combination therapy in smokers with different level of nicotine dependence and cigarette consumption.
      Results: Four randomized controlled trials involving a total of 1230 smokers were included. Compared with varenicline monotherapy, combination treatment with varenicline and bupropion could significantly improve the abstinence rate at the end of treatment (RR 1.153, 95% CI 1.019 to 1.305, P=0.024). The benefit existed at 6months follow-up (RR 1.231, 95% CI 1.017 to 1.490, P=0.033), disappeared at 12months follow-up (RR 1.130, 95% CI 0.894 to 1.428, P=0.305), and mainly concentrated in highly dependent smokers (RR 1.631, 95% CI 1.290 to 2.061, P<0.001) and heavy smokers (RR 1.515, 95% CI 1.226 to 1.873, P<0.001) rather than individuals with low nicotine dependence (RR 0.989, 95% CI 0.815 to 1.199, P=0.907) or low cigarette consumption (RR 0.985, 95% CI 0.800 to 1.212, P=0.252). For safety outcomes, the combination treatment was associated with more anxiety (RR 1.717, 95% CI 1.176 to 2.505, P=0.005) and insomnia (RR 1.268, 95% CI 1.076 to 1.494, P=0.005) symptoms compared with varenicline monotherapy.
      Conclusion: Compared with varenicline monotherapy, combination treatment with varenicline and bupropion can significantly improve the abstinence rate at the end of treatment and 6months follow-up, mainly in highly dependent smokers and heavy smokers.
      (Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: Bupropion; Combination; Smoking; Varenicline
    • Accession Number:
      0 (Nicotinic Agonists)
      0 (Smoking Cessation Agents)
      01ZG3TPX31 (Bupropion)
      W6HS99O8ZO (Varenicline)
    • Publication Date:
      Date Created: 20191101 Date Completed: 20200518 Latest Revision: 20200518
    • Publication Date:
      20240829
    • Accession Number:
      10.1016/j.comppsych.2019.152125
    • Accession Number:
      31669972