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Eficacia y seguridad del uso de medicamentos para la cesación de la adicción al tabaco: revisión de guías de práctica clínica. / [Efficacy and safety of medication use for the cessation of tobacco addiction: A review of Clinical Practice Guidelines].

Cañas, Alejandra; Alba, Luz-H; Becerra, Nelci; Murillo, Raúl; Páez, Nelson; Mosquera, Catalina.
Rev Salud Publica (Bogota); 16(5): 772-85, 2014 Sep-Oct.
Artigo em Espanhol | MEDLINE | 2014 | ID: mdl-26120760
Resumo: OBJECTIVE: To review the efficacy and safety of pharmacotherapy for smoking cessation in the context of clinical practice guidelines (CPG). METHODS: A systematic review of CPGs was conducted, aimed at adapting recommendations for Colombia following the ADAPTE methodology. Outcomes comprised 6-months or higher smoking cessation rates and intervention safety. CPGs were peer-assessed based on DELBI. Results from aggregative studies included in selected CPGs were obtained. RESULTS: Pharmacotherapy doubles smoking cessation rates as compared with placebos (rates @25% and up to 27 % when combined with counseling). The highest efficacy was observed for ansyolitic and antidepressive drugs (8.7 % to 19.4 %), and the lowest for nicotine replacement therapy -NRT- (5.2 % to 12.9 %). Nortriptiline shows an efficacy similar to that of bupropion (@10%). With limited exceptions, combined pharmacotherapy for smoking cessation has shown no significant increase in cessation rates. CONCLUSIONS: NRT, varenicline, bupropion and nortriptiline are effective treatments for smoking cessation. Combination of drugs deserves further clinical evidence and should be restricted to highly dependent smokers or initial therapeutic failure. Cost-effectiveness analyses might help to introduce smoking cessation programs in low and middle income countries.