Cholesteryl ester transfer protein inhibitors in the treatment of dyslipidemia: a systematic review and meta-analysis.
Cholesteryl ester transfer protein inhibitors in the treatment of dyslipidemia: a systematic review and meta-analysis.
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胆固醇酯转移蛋白抑制剂治疗血脂异常：系统评价和荟萃分析。
DOI：
10.1371/journal.pone.0077049
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Zeng C
中科院分区：
文献类型：
--
作者：
Li C;Zhang W;Zhou F;Chen C;Zhou L;Li Y;Liu L;Pei F;Luo H;Hu Z;Cai J;Zeng C
胆固醇酯转移蛋白 (CETP) 抑制剂因提高高密度脂蛋白胆固醇水平而引起广泛的研究兴趣。该研究的目的是评估胆固醇酯转移蛋白抑制剂作为新型调脂药物的功效和安全性。从 MEDLINE、EBASE、CENTRAL 和符合条件的研究中列出的参考文献中收集了随机对照试验 (RCT) 的英文文献的系统检索。两位独立作者评估了搜索结果，仅纳入了双盲随机对照试验，即仅使用胆固醇酯转移蛋白抑制剂或与他汀类药物联合用药，无论入组成年受试者的性别如何。两位独立作者使用预定义的数据字段提取数据。在确定的 503 项研究中，14 项研究符合纳入标准，12 项研究纳入最终荟萃分析。我们的荟萃分析显示，CETP抑制剂增加了HDL-c水平（n = 2826，p<0.00001，平均差（MD） = 20.47，95% CI [19.80至21.15]）和总胆固醇（n = 3423，p = 0.0002， MD = 3.57，95%CI [1.69 至 5.44] 在某种程度上与甘油三酯的降低 (n = 3739，p<0.00001，MD = −10.47，95% CI [−11.91 至 -9.03]) 和 LDL-c 降低相结合(n = 3159，p<0.00001，MD = −17.12，95% CI [−18.87 至 -15.36])，无论是单一治疗还是与他汀类药物联合用药。亚组分析表明，与对照相比，目前可用的四种 CETP 抑制剂治疗的脂质调节效果并不增加。观察到血压略有升高（SBP，n = 2384，p <0.00001，MD = 2.73，95％CI [2.14至3.31]，DBP，n = 2384，p<0.00001，MD = 1.16，95％CI [0.73至3.31] 1.60]）在CETP抑制剂治疗后，这主要归因于torcetrapib治疗亚组，CETP抑制剂治疗与血脂异常患者的HDL-c显着升高以及甘油三酯和LDL-c降低相关，且安全性和耐受性令人满意，但在未来的研究中值得更多考虑。
Cholesteryl ester transfer protein (CETP) inhibitors are gaining substantial research interest for raising high density lipoprotein cholesterol levels. The aim of the research was to estimate the efficacy and safety of cholesteryl ester transfer protein inhibitors as novel lipid modifying drugs. Systematic searches of English literature for randomized controlled trials (RCT) were collected from MEDLINE, EBASE, CENTRAL and references listed in eligible studies. Two independent authors assessed the search results and only included the double-blind RCTs by using cholesteryl ester transfer protein inhibitors as exclusively or co-administrated with statin therapy irrespective of gender in enrolled adult subjects. Two independent authors extracted the data by using predefined data fields. Of 503 studies identified, 14 studies met the inclusion criteria, and 12 studies were included into the final meta-analysis. Our meta-analysis revealed that CETP inhibitors increased the HDL-c levels (n = 2826, p<0.00001, mean difference (MD) = 20.47, 95% CI [19.80 to 21.15]) and total cholesterol (n = 3423, p = 0.0002, MD = 3.57, 95%CI [1.69 to 5.44] to some extent combined with a reduction in triglyceride (n = 3739, p<0.00001, MD = −10.47, 95% CI [−11.91 to −9.03]) and LDL-c (n = 3159, p<0.00001, MD = −17.12, 95% CI [−18.87 to −15.36]) irrespective of mono-therapy or co-administration with statins. Subgroup analysis suggested that the lipid modifying effects varied according to the four currently available CETP inhibitors. CETP inhibitor therapy did not increase the adverse events when compared with control. However, we observed a slight increase in blood pressure (SBP, n = 2384, p<0.00001, MD = 2.73, 95% CI [2.14 to 3.31], DBP, n = 2384, p<0.00001, MD = 1.16, 95% CI [0.73 to 1.60]) after CETP inhibitor treatment, which were mainly ascribed to the torcetrapib treatment subgroup. CETP inhibitors therapy is associated with significant increase in HDL-c and decrease in triglyceride and LDL-c with satisfactory safety and tolerability in patients with dyslipidemia. However, the side-effect on blood pressure deserves more consideration in future studies.
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作者：
Hozo SP;Djulbegovic B;Hozo I
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