磷酸二酯酶 5 抑制剂与黑色素瘤风险：一项荟萃分析。

Phosphodiesterase type 5 inhibitors and risk of melanoma: A meta-analysis.

机构信息

Department of Pharmacy, Peking University Third Hospital, Beijing, China; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.

Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana.

出版信息

J Am Acad Dermatol. 2017 Sep;77(3):480-488.e9. doi: 10.1016/j.jaad.2017.04.1129. Epub 2017 Jul 18.

DOI:10.1016/j.jaad.2017.04.1129

PMID:28728871

Abstract

BACKGROUND

The association between phosphodiesterase type 5 (PDE5) inhibitors and melanoma risk is controversial.

OBJECTIVE

We quantify the association between use of PDE5 inhibitors and melanoma.

METHODS

We systematically searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov for studies that were conducted up to July 13, 2016, and evaluated the association between PDE5 inhibitors and skin cancer. Random effects meta-analyses were used to calculate the adjusted odds ratio (OR) with the 95% confidence interval (CI).

RESULTS

Five observational studies were included. Compared with PDE5 inhibitor nonuse, PDE5 inhibitor use was slightly but significantly associated with an increased risk for development of melanoma (OR, 1.12; 95% CI, 1.03-1.21) and basal cell carcinoma (OR, 1.14; 95% CI, 1.09-1.19) but not squamous cell carcinoma. For melanoma risk, none of the prespecified factors (dose of PDE5 inhibitor, study design, and study region) significantly affected the results (P > .05). Our sensitivity analysis confirmed the stability of the results.

LIMITATIONS

We included only observational studies, which had some heterogeneities and inconsistent controlling for potential confounders.

CONCLUSIONS

Use of PDE5 inhibitors may be associated with a slightly increased risk for development of melanoma and basal cell carcinoma but not squamous cell carcinoma. However, further large well-conducted prospective studies with adequate adjustment for potential confounders are required for confirmation.

摘要

背景

磷酸二酯酶 5（PDE5）抑制剂与黑色素瘤风险之间的关联存在争议。

目的

我们定量评估 PDE5 抑制剂的使用与黑色素瘤之间的相关性。

方法

我们系统地检索了 PubMed、Embase、Cochrane 中心对照试验注册库、Web of Science 和 ClinicalTrials.gov，检索截至 2016 年 7 月 13 日的研究，评估 PDE5 抑制剂与皮肤癌之间的相关性。使用随机效应荟萃分析计算调整后的比值比（OR）及其 95％置信区间（CI）。

结果

共纳入 5 项观察性研究。与 PDE5 抑制剂不使用者相比，PDE5 抑制剂使用者发生黑色素瘤（OR，1.12；95％CI，1.03-1.21）和基底细胞癌（OR，1.14；95％CI，1.09-1.19）的风险略有但显著增加，但鳞状细胞癌风险无显著增加。对于黑色素瘤风险，未预设的因素（PDE5 抑制剂剂量、研究设计和研究区域）均无显著影响结果（P＞0.05）。我们的敏感性分析证实了结果的稳定性。