老年人应用他汀致癌风险Meta分析

目的评价老年人(≥60岁)应用他汀是否会增加致癌风险。方法全面检索2015年12月前发表的关于老年人(≥60岁)应用他汀治疗的随机对照研究(RCTs),筛选出其中有关他汀与安慰剂比较,并有癌症风险报道的研究,评价所纳入研究的文献质量,提取有效数据。采用Rev Man 5.3软件进行Meta分析,评价文献的发表偏倚及异质性,采用相对危险度(RR)分析统计量,各效应量均给出其95%可信区间(CI)。结果共纳入12项研究,合计62 927例患者(他汀治疗组31 517例,对照组31 410例),随访1.9~5.4年。Meta分析结果显示,他汀治疗组与对照组相比,癌症的发生率并没有显著增加(RR=1.04,95%CI 0.98~1.10,P=0.19),水溶性他汀(RR=1.06,95%CI 0.93~1.21,P=0.35)、脂溶性他汀(RR=0.99,95%CI 0.88~1.11,P=0.83)均不会增加致癌风险。结论老年人应用他汀不会增加致癌风险,无论水溶性他汀还是脂溶性他汀,都不会增加致癌风险,但还需随访时间更长的研究进一步证实。

Cancer risk in older people receiving statin therapy:a meta-analysis of randomized controlled trials

Objective To determine the risk of cancer in people aged over 60 years receiving statin therapy. Methods A comprehensive search for articles published up to December 2015 was performed,reviews of each randomized controlled trials (RCTs) that compared the effects of statin monotherapy with placebo on the risk of cancer in people aged ≥ 60 years were conducted and data abstracted. All the included studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using RevMan 5.3 software. Results A total of 12 RCTs, involving 62,927 patients (31,517 in statin therapy group and 31,410 in control group),with a follow-up duration of 1.9-5.4 years, contributed to the analysis. The statin therapy did not affect the overall incidence of cancer (RR=1.04,95%CI 0.98~1.10,P=0.19);subgroup analyses showed that neither the hydrophilic (RR=1.06,95%CI 0.93 ~ 1.21,P=0.35) nor lipophilic statins (RR=0.99,95%CI 0.88 ~ 1.11,P=0.83) accounted for the incidence of cancer in older people. Conclusion Our meta-analysis findings do not support a potential cancer risk of statin treatment in people over 60 years old. Further targeted research with a longer follow-up duration are warranted to confirm this issue.