Zhou Junteng, Zhang Qi, Wang Yushu, Gao Peijuan, Chen Decai
a Department of Cardiology , Sichuan University West China Hospital , Chengdu , China.
b Department of Endocrinology and Metabolism , Sichuan University West China Hospital , Chengdu , China.
Postgrad Med. 2018 Jan;130(1):129-136. doi: 10.1080/00325481.2018.1401421. Epub 2017 Nov 14.
Cardiovascular disease (CVD) is the major cause of morbidity and mortality worldwide. Anacetrapib may be a new treatment option that has a cardiovascular benefit for the management of dyslipidemia.
The aim of our current study was to perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) assessing the effect and safety of anacetrapib in the treatment of dyslipidemia.
We systematically searched PubMed, Embase, and Cochrane Library database from their inception to 5 October 2017, with the terms: 'anacetrapib' and 'placebo'. From 287 initial citations, 10 studies including 34781 patients with dyslipidemia were included in the final systematic review and meta-analysis.
Pooled results showed that anacetrapib significantly increased high density lipoprotein cholesterol (HDL-C) [weighted mean differences (WMD) 53.07, 95% confidence interval (95% CI) 46.79 to 59.36] and apolipoprotein AI (ApoAI) (WMD 53.44, 95% CI 45.72 to 61.16). Our study also showed that anacetrapib significantly reduced low density lipoprotein cholesterol (LDL-C) (WMD -32.99; 95% CI -37.13 to -28.86), Non-HDL-C (WMD -39.19; 95% CI -52.22 to -26.16), triglycerides (TG) (WMD -9.97; 95% CI -10.54 to -9.41), apolipoprotein B (ApoB) (WMD -22.55; 95% CI -28.56 to -16.54) and lipoprotein a [LP(a)] (WMD -13.35; 95% CI -18.31 to -8.39). Our results demonstrated that there was no significant difference in all the following adverse events between the anacetrapib group and placebo group: [hepato-toxicity (OR 0.90, 95% CI: 0.75 to 1.07); musculoskeletal injury (OR 1.01, 95% CI: 0.88 to 1.15); drug-related adverse event (OR 1.00, 95% CI: 0.96 to 1.05); drug-related withdrawn (OR 1.01, 95% CI: 0.95 to 1.08)].
Although further studies are needed, our findings clearly offer support to the use of anacetrapib in the clinical management of patients with dyslipidemia.
心血管疾病（CVD）是全球发病和死亡的主要原因。阿那曲泊帕可能是一种对血脂异常管理具有心血管益处的新治疗选择。
我们当前研究的目的是对所有评估阿那曲泊帕治疗血脂异常的疗效和安全性的随机对照试验（RCT）进行系统评价和荟萃分析。
我们系统检索了PubMed、Embase和Cochrane图书馆数据库，检索时间从建库至2017年10月5日，检索词为：“阿那曲泊帕”和“安慰剂”。从287条初始引文中共纳入10项研究，包括34781例血脂异常患者，进行最终的系统评价和荟萃分析。
汇总结果显示，阿那曲泊帕显著升高高密度脂蛋白胆固醇（HDL-C）[加权均数差（WMD）53.07，95%置信区间（95%CI）46.79至59.36]和载脂蛋白AI（ApoAI）（WMD 53.44，95%CI 45.72至61.16）。我们的研究还表明，阿那曲泊帕显著降低低密度脂蛋白胆固醇（LDL-C）（WMD -32.99；95%CI -37.13至-28.86）、非HDL-C（WMD -39.19；95%CI -52.22至-26.16）、甘油三酯（TG）（WMD -9.97；95%CI -10.54至-9.41）、载脂蛋白B（ApoB）（WMD -22.55；95%CI -28.56至-16.54）和脂蛋白a [LP(a)]（WMD -13.35；95%CI -18.31至-8.39）。我们的结果表明，阿那曲泊帕组和安慰剂组在以下所有不良事件方面无显著差异：[肝毒性（OR 0.90，95%CI：0.75至1.07）；肌肉骨骼损伤（OR 1.01，95%CI：0.88至1.15）；药物相关不良事件（OR 1.00，95%CI：0.96至1.05）；药物相关撤药（OR 1.01，95%CI：0.95至1.08）]。
尽管需要进一步研究，但我们的研究结果明确支持在血脂异常患者的临床管理中使用阿那曲泊帕。
