Cytisine疗法改善肺癌流行病学筛查与多重干预试验中的戒烟情况

Cytisine Therapy Improved Smoking Cessation in the Randomized Screening and Multiple Intervention on Lung Epidemics Lung Cancer Screening Trial

（J Thorac Oncol；IF: 20.121）

Pastorino U, Ladisa V, Trussardo S, et al. Cytisine Therapy Improved Smoking Cessation in the Randomized Screening and Multiple Intervention on Lung Epidemics Lung Cancer Screening Trial [published online ahead of print, 2022 Jul 28]. J Thorac Oncol. 2022;S1556-0864(22)00346-X. doi:10.1016/j.jtho.2022.07.007Corresponding author : ugo.pastorino@istitutotumori.mi.it

Introduction 引言

Cytisine, a partial agonist-binding nicotine acetylcholine receptor, is a promising cessation intervention. We conducted a single-center, randomized, controlled trial (RCT) in Italy to assess the efficacy and tolerability of cytisine as a smoking cessation therapy among lung cancer screening participants.

Cytisine是一种结合尼古丁乙酰胆碱受体的部分激动剂，是一种极具前景的戒烟干预措施。我们在意大利进行了一项单中心随机对照试验 (RCT)，以评估Cytisine作为肺癌筛查参与者戒烟治疗的疗效和耐受性。

Methods 方法

From July 2019 to March 2020, the Screening and Multiple Intervention on Lung Epidemics RCT enrolled 869 current heavy tobacco users in a low-dose computed tomography screening program, with a randomized comparison of pharmacologic intervention with cytisine plus counseling (N = 470) versus counseling alone (N = 399). The primary outcome was continuous smoking abstinence at 12 months, biochemically verified through carbon monoxide measurement.

从 2019 年 7 月到 2020 年 3 月，肺流行病学筛查和多重干预 (SMILE) RCT 在低剂量计算机断层扫描 (LDCT) 筛查项目中招募了 869 名当前重度吸烟者，随机比较了通过Cytisine这一药物干预加健康咨询（N = 470）与仅健康咨询（N = 399）。主要结果是连续戒烟12个月，通过一氧化碳 (CO) 测量进行生化验证。

Results 结果

At the 12-month follow-up, the quit rate was 32.1% (151 participants) in the intervention arm and 7.3% (29 participants) in the control arm. The adjusted OR of continuous abstinence was 7.2 (95% confidence interval: 4.6-11.2). Self-reported adverse events occurred more frequently in the intervention arm (399 events among 196 participants) than in the control arm (230 events among 133 participants, p

在 12 个月的随访中，干预组的戒烟率为 32.1%（151 名参与者），对照组的戒烟率 7.3%（29 名参与者）。连续戒烟的调整优势比 (OR) 为 7.2（95% 置信区间，4.6 至 11.2）。自我报告的不良事件 (AE)在干预组（196 名参与者中的 399 起事件）中比对照组（133 名参与者中的 230 起事件；p

Conclusions 结论

The efficacy and safety observed in the Screening and Multiple Intervention on Lung Epidemics RCT indicate that cytisine, a very low-cost medication, is a useful treatment option for smoking cessation and a feasible strategy to improve low-dose computed tomography screening outcomes with a potential benefit for all-cause mortality.

在 SMILE RCT 中观察到的疗效和安全性表明，Cytisine作为一种成本极低的药物，对戒烟而言是一种有效的方案，也是改善LDCT 筛查结果的可行策略，对其全因死亡率具有潜在益处。