Can statin therapy reduce the risk of melanoma? A meta-analysis of randomized controlled trials
Can statin therapy reduce the risk of melanoma? A meta-analysis of randomized controlled trials
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DOI：
10.1007/s10654-009-9396-x
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发表时间：
2010-01-01
影响因子：
13.6
通讯作者：
Sitaras, Nikolaos M.
中科院分区：
文献类型：
--
作者：
Bonovas, Stefanos;Nikolopoulos, Georgios;Sitaras, Nikolaos M.
越来越多的文献表明，他汀类药物可能通过多效抗炎、免疫调节和抗血管生成机制对黑色素瘤具有化学预防潜力。我们的目的是通过对随机对照试验（RCT）进行详细的荟萃分析来检查这种关联。对截至2009年6月发表的试验进行了全面检索，对每项研究进行了审查，并提取了数据。在荟萃分析之前，对研究的发表偏倚和异质性进行了评价。使用固定效应和随机效应模型计算合并相对风险估计值（RR）和95%置信区间（CI）。还进行了亚组和敏感性分析。16项他汀类药物治疗心血管结局的RCT，涉及62，568名平均年龄为60岁的个体，平均随访时间近4.7年，有助于分析。我们没有发现发表偏倚（P = 0.47）或研究异质性（P = 0.25）的证据。假设固定效应模型（RR = 0.92，95%CI：0.67-1.26）或随机效应模型（RR = 0.92，95%CI：0.62-1.36），他汀类药物的使用对发生黑色素瘤的风险没有显著影响。亚组和敏感性分析的结果进一步支持了这种中性效应。我们的研究结果不支持他汀类药物对黑色素瘤的保护作用。
A growing body of literature suggests that statins may have a chemopreventive potential against melanoma through pleiotropic anti-inflammatory, immunomodulatory, and antiangiogenesis mechanisms. Our aim was to examine this association through a detailed meta-analysis of randomized controlled trials (RCTs). A comprehensive search for trials published up to June 2009 was performed, reviews of each study were conducted and data were abstracted. Prior to meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk estimates (RR) and 95% confidence intervals (CIs) were calculated using the fixed- and the random-effects models. Subgroup and sensitivity analyses were also conducted. Sixteen RCTs of statins for cardiovascular outcomes, involving 62,568 individuals with a mean age of 60 years and an average follow-up of nearly 4.7 years, contributed to the analysis. We found no evidence of publication bias (P = 0.47) or heterogeneity among the studies (P = 0.25). Statin use did not significantly affect the risk of developing melanoma assuming either a fixed- (RR = 0.92, 95% CI: 0.67-1.26), or a random-effects model (RR = 0.92, 95% CI: 0.62-1.36). This neutral effect was further supported by the results of subgroup and sensitivity analyses. Our findings do not support a protective effect of statins against melanoma.