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普伐他汀的使用与癌症风险:来自日本长期前瞻性对照临床试验的个体患者数据的荟萃分析。

Pravastatin use and cancer risk: a meta-analysis of individual patient data from long-term prospective controlled trials in Japan.

机构信息

Clinical Data and Biostatistics Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan.

出版信息

Pharmacoepidemiol Drug Saf. 2010 Feb;19(2):196-202. doi: 10.1002/pds.1870.

Abstract

PURPOSE

To assess the influence of pravastatin therapy on cancer morbidity and mortality by a meta-analysis of individual patient data (IPD) from three independent Japanese large-scale clinical trials.

METHODS

We conducted a meta-analysis of IPD collected from three large-scale prospective studies, the Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study, Kyushu Lipid Intervention Study (KLIS), and Hokuriku Lipid Coronary Heart Disease Study-Pravastatin Atherosclerosis Trial (Holicos-PAT), which compared cardiovascular outcomes with pravastatin therapy and non-statin therapy in Japanese patients with hypercholesterolemia over a follow-up period of >or=4 years. The incidence of cancer or cancer death in the pravastatin and non-statin therapy groups was compared by multivariate Cox proportional hazard models stratified by trial. Subgroup analyses by sex and age were also conducted using the same methods.

RESULTS

In a total of 13 724 patients (mean age, 58 years; women, 48%) included in the analyses, pravastatin was not associated with an increased risk of developing cancer (hazard ratio [HR], 0.99; 95% confidence interval [95%CI], 0.81-1.19). Similarly, pravastatin therapy did not statistically affect cancer death (HR, 0.86; 95%CI, 0.61-1.21). Moreover, in subgroups analyses, no influence was observed on cancer incidence or death in relation to sex and age.

CONCLUSION

Pravastatin did not increase the rate of cancer incidence or cancer death in a large population of Japanese patients followed for >70,000 patient-years.

摘要

目的

通过对来自三个独立的日本大规模临床试验的个体患者数据(IPD)的荟萃分析,评估普伐他汀治疗对癌症发病率和死亡率的影响。

方法

我们对来自三个大规模前瞻性研究的 IPD 进行了荟萃分析,这些研究分别是日本成人血脂异常一级预防研究(MEGA 研究)、九州血脂干预研究(KLIS)和北陆脂质冠心病研究-普伐他汀动脉粥样硬化试验(Holicos-PAT),这些研究比较了日本高胆固醇血症患者接受普伐他汀治疗和非他汀治疗在超过 4 年的随访期间的心血管结局。通过按试验分层的多变量 Cox 比例风险模型比较了普伐他汀和非他汀治疗组的癌症发生率或癌症死亡。还使用相同的方法进行了按性别和年龄分层的亚组分析。

结果

在总共纳入的 13724 例患者(平均年龄 58 岁;女性占 48%)中,普伐他汀治疗与癌症风险增加无关(风险比 [HR],0.99;95%置信区间 [95%CI],0.81-1.19)。同样,普伐他汀治疗也不会对癌症死亡产生统计学影响(HR,0.86;95%CI,0.61-1.21)。此外,在亚组分析中,在性别和年龄亚组中,普伐他汀治疗对癌症发病率或死亡率也没有影响。

结论

在超过 70000 患者年的随访中,普伐他汀并未增加日本患者的癌症发病率或癌症死亡率。

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