1 / 8

Cytisine for smoking cessation

Cytisine for smoking cessation. A literature review and a meta-analysis Jean-François ETTER, PhD Institute of social and preventive medicine University of Geneva - Switzerland E-mail: JFE@JFE.CH August 28, 2006. Background.

ziven
Download Presentation

Cytisine for smoking cessation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Cytisine for smoking cessation A literature review and a meta-analysis Jean-François ETTER, PhD Institute of social and preventive medicine University of Geneva - Switzerland E-mail: JFE@JFE.CH August 28, 2006

  2. Background • Cytisine is found in the seeds of the golden rain tree (Cytisus laburnum). • Cytisine (not to be confounded with cytosine) is an agonist of nicotinic receptors, it binds strongly to alpha4-beta2 nicotinic receptors. • Varenicline is derived from cytisine. • Cytisine has been used to treat tobacco dependence for 40 years in Eastern Europe. • Cytisine is sold as a smoking cessation drug by a Bulgarian firm under the commercial name of Tabex • See www.tabex.net

  3. Objectives • To review the literature on the effect of cytisine on smoking cessation. • To conduct a meta-analysis of placebo-controlled trials.

  4. Data sources • We reviewed: . PubMed, . Embase, . Psychological Abstracts, . Biosis, . Google.com and Scholar.google.com, • Using the keywords cytisine, cytisin, zytisin, cytisinum, Tabex and smoking cessation, and • We contacted experts in several countries and the producer of Tabex. • We obtained professional translations of articles in Polish, Bulgarian, Russian and German

  5. Data synthesis • We found 10 studies reporting on the effects of cytisine on smoking cessation, • Including 4 controlled studies (3 placebo-controlled). • 9 studies used the Bulgarian drug Tabex, containing 1.5 mg cytisine per tablet. • One Russian study used buccal films containing either 1.5 mg cytisine or 0.75 mg cytisine plus 0.75 mg anabasine. • All studies were published between 1967 and 2005 in Bulgaria, Germany, Poland and Russia.

  6. Data synthesis • There were 4427 smokers treated with cytisine and 3518 smokers in control conditions. • The pooled odds ratio after 3-8 weeks in the 3 placebo-controlled trials (two were doubled-blind and one was randomized) was 1.93 (95% CI: 1.21 to 3.06). • For the 2 placebo-controlled, double-blind trials with longer follow-up, the pooled odds ratio after 3-6 months was 1.83 (1.12 to 2.99). • One placebo-controlled, double-blind trial had follow-up after 2 years (odds ratio=1.77, 1.29 to 2.43). • Some side effects were reported.

  7. Meta-analysis of the effect of cytisine versus placebo on smoking cessation at the end of treatment, after 3-8 weeks

  8. Conclusions • Cytisine is very probably effective for smoking cessation. • Studies of poor methodological quality. • This fact remained largely unnoticed in the English-language literature. • How many other effective drugs are there, which remained unnoticed because efficacy trials were never published in English in Western countries? Competing interests: none Funding: none • Paper published as: Cytisine for smoking cessation: a literature review and a meta-analysis. Arch Intern Med. 2006;166:1553-9.

More Related