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他莫昔芬的使用与老年乳腺癌女性患帕金森病的风险增加相关:台湾的一项病例对照研究。

Tamoxifen usage correlates with increased risk of Parkinson's disease in older women with breast cancer: a case-control study in Taiwan.

作者信息

Lin Hsien-Feng, Liao Kuan-Fu, Chang Ching-Mei, Lin Cheng-Li, Lai Shih-Wei

机构信息

School of Chinese Medicine, China Medical University, Taichung, Taiwan.

Department of Family Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung City, 404, Taiwan.

出版信息

Eur J Clin Pharmacol. 2018 Jan;74(1):99-107. doi: 10.1007/s00228-017-2341-0. Epub 2017 Oct 1.

Abstract

BACKGROUND AND OBJECTIVES

Little is known about the association between tamoxifen usage and risk of Parkinson's disease in women with breast cancer. The present study aimed to evaluate the association between tamoxifen usage and Parkinson's disease in older women with breast cancer in Taiwan.

METHODS

We conducted a retrospective nationwide case-control study using the database of the Taiwan National Health Insurance Program. In total, 293 female subjects with breast cancer, aged 65 years and above, who were newly diagnosed with Parkinson's disease between 2000 and 2011 were included. Additionally, 1053 female subjects with breast cancer aged 65 years and above without Parkinson's disease were randomly selected as controls. Both cases and controls were matched for age and comorbidities. Ever use of tamoxifen was defined as subjects who had at least a prescription for tamoxifen before the index date, whereas never use of tamoxifen was defined as those who never had a prescription for tamoxifen before the index date. We used the unconditional logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) for the association between tamoxifen usage and risk of Parkinson's disease.

RESULTS

After adjusting for confounding variables, the adjusted OR of Parkinson's disease was 3.32 for subjects with ever use of tamoxifen (95% CI, 2.50-4.43), compared with nonusers. Further analysis showed that the adjusted ORs of Parkinson's disease were 3.21 (95% CI, 2.29-4.49), 3.95 (95% CI, 2.77-5.64), and 11.4 (95% CI, 2.63-49.7) for subjects with < 2, 2-6, and ≥ 6 years of cumulative tamoxifen usage, respectively, when compared with nonusers.

CONCLUSIONS

Tamoxifen usage was associated with a 3.32-fold increase in the likelihood of having Parkinson's disease among older women with breast cancer in Taiwan.

摘要

背景与目的

关于他莫昔芬的使用与乳腺癌女性患帕金森病风险之间的关联,人们了解甚少。本研究旨在评估台湾老年乳腺癌女性中他莫昔芬的使用与帕金森病之间的关联。

方法

我们利用台湾全民健康保险计划的数据库进行了一项全国性回顾性病例对照研究。总共纳入了293名65岁及以上的乳腺癌女性受试者,她们在2000年至2011年间新诊断出患有帕金森病。此外,随机选择1053名65岁及以上无帕金森病的乳腺癌女性受试者作为对照。病例组和对照组在年龄和合并症方面进行了匹配。曾经使用他莫昔芬定义为在索引日期之前至少有一张他莫昔芬处方的受试者,而从未使用他莫昔芬定义为在索引日期之前从未有过他莫昔芬处方的受试者。我们使用无条件逻辑回归模型来计算他莫昔芬使用与帕金森病风险之间关联的比值比(OR)和95%置信区间(CI)。

结果

在调整混杂变量后,曾经使用他莫昔芬的受试者患帕金森病的调整后OR为3.32(95%CI,2.50 - 4.43),与未使用者相比。进一步分析表明,与未使用者相比,累积使用他莫昔芬<2年、2 - 6年和≥6年的受试者患帕金森病的调整后OR分别为3.21(95%CI,2.29 - 4.49)、3.95(95%CI,2.77 - 5.64)和11.4(95%CI,2.63 - 49.7)。

结论

在台湾老年乳腺癌女性中,使用他莫昔芬使患帕金森病的可能性增加了3.32倍。

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