BACKGROUND Smoking rates are high in adults with anxiety disorders (ADs), yet little is known about the safety and efficacy of smoking-cessation pharmacotherapies in this group. METHODS Post hoc analyses in 712 smokers with AD (posttraumatic stress disorder [PTSD], n = 192; generalized anxiety disorder [GAD], n = 243; panic disorder [PD], n = 277) and in a nonpsychiatric cohort (NPC; n = 4,028). Participants were randomly assigned to varenicline, bupropion, nicotine-replacement therapy (NRT), or placebo plus weekly smoking-cessation counseling for 12 weeks, with 12 weeks follow-up. General linear models were used to test the effects of treatment group, cohort, and their interaction on neuropsychiatric adverse events (NPSAEs), and continuous abstinence weeks 9-12 (treatment) and 9-24 (follow-up). RESULTS NPSAE incidence for PTSD (6.9%), GAD (5.4%), and PD (6.2%) was higher versus NPC (2.1%), regardless of treatment. Across all treatments, smokers with PTSD (odds ratio [OR] = 0.58), GAD (OR = 0.72), and PD (OR = 0.53) had lower continuous abstinence rates weeks 9-12 (CAR9-12) versus NPC. Varenicline demonstrated superior efficacy to placebo in smokers with GAD and PD, respectively (OR = 4.53; 95% confidence interval [CI] = 1.20-17.10; and OR = 8.49; 95% CI = 1.57-45.78); NRT was superior to placebo in smokers with PD (OR = 7.42; 95% CI = 1.37-40.35). While there was no statistically significant effect of any treatment on CAR9-12 for smokers with PTSD, varenicline improved 7-day point prevalence abstinence at end of treatment in this subcohort. CONCLUSION Individuals with ADs were more likely than those without psychiatric illness to experience moderate to severe NPSAEs during smoking-cessation attempts, regardless of treatment. While the study was not powered to evaluate abstinence outcomes with these subgroups of smokers with ADs, varenicline provided significant benefit for cessation in those with GAD and PD, while NRT provided significant benefit for those with PD.

中文翻译：

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焦虑症中戒烟药物治疗的功效和安全性：随机，有效和安慰剂对照的EAGLES试验的亚组分析。

背景技术在患有焦虑症（AD）的成年人中吸烟率很高，但是对于这一组戒烟药物治疗的安全性和功效知之甚少。方法对712名吸烟者（非创伤性应激障碍[PTSD]，n = 192；广泛性焦虑症[GAD]，n = 243；恐慌症[PD]，n = 277）和非精神病学队列（NPC）进行事后分析。 n = 4,028）。参与者被随机分配到伐尼克兰，安非他酮，尼古丁替代疗法（NRT）或安慰剂加上每周戒烟咨询，为期12周，并随访12周。使用一般线性模型来测试治疗组，队列及其相互作用对神经精神病学不良事件（NPSAE）和第9-12周（治疗）和9-24周（随访）的持续禁欲的影响。结果PTSD（6.9％），GAD（5。无论采用何种治疗方法，PD（6.2％）均高于NPC（2.1％）。在所有治疗中，与NPC相比，PTSD（优势比[OR] = 0.58），GAD（OR = 0.72）和PD（OR = 0.53）的吸烟者连续戒酒率较低（第9-12周）。在具有GAD和PD的吸烟者中，瓦伦尼克林表现出优于安慰剂的疗效（OR = 4.53； 95％置信区间[CI] = 1.20-17.10； OR = 8.49； 95％CI = 1.57-45.78）；在PD的吸烟者中，NRT优于安慰剂（OR = 7.42； 95％CI = 1.37-40.35）。尽管对于患有PTSD的吸烟者，CAR9-12的任何治疗均无统计学显着效果，但在该亚人群中，缬沙胺改善了治疗结束后7天的戒断率。结论患有AD的个体比没有精神病的个体在戒烟尝试中经历中度至重度NPSAE的可能性更高，而与治疗无关。尽管该研究没有能力评估这些患有AD的吸烟者亚组的戒断结局，但缬沙酸对GAD和PD的戒烟提供了显着的益处，而NRT为PD的戒烟提供了显着的益处。