Are there sex differences in transdermal nicotine replacement therapy patch efficacy? A meta-analysis.
Smoking-related death and disability rates for women have risen sharply recently. Despite lower smoking cessation success rates for women using behavioral therapies, data are limited on whether specific pharmacological therapies are equally efficacious in men and women. Using meta-analytic techniques, we examined whether significant differences in therapeutic efficacy of nicotine replacement therapy (NRT) for smoking cessation exist by sex. Out of the 31 randomized clinical trials of NRT that met inclusion criteria, 11 contributed to the analysis. The odds ratios for NRT vs. placebo were derived from each trial separately by sex for males and females, and these ratios were combined to give a pooled estimate of the effect of sex in response to NRT. NRT was effective at all time points in men (< 6 months: OR = 2.05, 95% CI= 1.61-2.60; 6 months: OR = 1.98, 95% CI = 1.51-2.60; 12 months: OR = 1.86, 95% CI = 1.39-2.50) and women (< 6 months: OR = 2.09, 95% CI = 1.65-2.65; 6 months, OR = 1.52, 95% CI = 1.17-1.98; 12 months: OR = 1.63, 95% CI = 1.22-2.18). At all time points, no significant difference was observed between sexes (< 6 months: OR = .97, 95% CI = .69-1.36; 6 months: OR = 1.33, 95% CI = .91-1.95; 12 months: OR = 1.21, 95% CI = .79-1.84). The results of this meta-analysis do not support the hypothesis that NRT has higher therapeutic efficacy for men than women.
Munafò
Marcus
M
Cancer Research UK General Practice Research Group, Department of Clinical Pharmacology, University of Oxford, Oxford OX2 6HE, UK. marcus.munafo@clinpharm.ox.ac.uk
Bradburn
Mike
M
Bowes
Lucy
L
David
Sean
S
D000279:Administration, Cutaneous; D000328:Adult; D004608:Eligibility Determination; D005731:Ganglionic Stimulants / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D009538:Nicotine / Q000008:administration & dosage* / Q000627:therapeutic use*; D016017:Odds Ratio; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D016896:Treatment Outcome
D005731:Ganglionic Stimulants; D009538:Nicotine