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他汀类药物使用与带状疱疹的关联:系统评价和荟萃分析。

Association between statin use and herpes zoster: systematic review and meta-analysis.

机构信息

Department of Urology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Department of Rehabilitation, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

BMJ Open. 2019 Feb 13;9(2):e022897. doi: 10.1136/bmjopen-2018-022897.

Abstract

OBJECTIVE

Statins are commonly prescribed worldwide. In addition to being potent lipid-lowering agents, statins have immunomodulating properties that may increase the risk of varicella zoster virus reactivation. This adverse effect may have substantial public health implications.

DESIGN

We performed a meta-analysis of observational studies to assess the association between statin use and the risk of herpes zoster infection. We searched PubMed, Embase, Web of Science and Cochrane databases to identify studies published from 1980 to 2018. The multivariate-adjusted ORs were pooled using random-effect models, and subgroup and sensitivity analyses were performed to examine the source of heterogeneity.

RESULT

Six studies were analysed, with a total of more than two million participants. We determined if the use of statins might increase the risk of infection of herpes zoster (OR 1.18, 95% CI 1.11 to 1. 25). We detected significant heterogeneity (I=91.2%; p<0.000), and determined that the heterogeneity arises from regional differences.

CONCLUSION

The use of statins may increase the risk of herpes zoster infection. Because the studies included are limited and there may be potential bias, further studies are warranted.

摘要

目的

他汀类药物在全球范围内广泛应用。除了具有强效的降脂作用外,他汀类药物还具有免疫调节特性,可能会增加水痘-带状疱疹病毒再激活的风险。这种不良反应可能具有重要的公共卫生意义。

设计

我们对观察性研究进行了荟萃分析,以评估他汀类药物使用与带状疱疹感染风险之间的关系。我们检索了 PubMed、Embase、Web of Science 和 Cochrane 数据库,以确定从 1980 年到 2018 年发表的研究。使用随机效应模型对多变量校正的 OR 值进行汇总,并进行亚组和敏感性分析以检查异质性的来源。

结果

分析了 6 项研究,总计超过 200 万名参与者。我们确定他汀类药物的使用是否可能增加带状疱疹感染的风险(OR 1.18,95%CI 1.11 至 1.25)。我们检测到显著的异质性(I=91.2%;p<0.000),并且确定异质性源自区域差异。

结论

他汀类药物的使用可能会增加带状疱疹感染的风险。由于纳入的研究有限且可能存在潜在的偏倚,因此需要进一步的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61fb/6398719/141b92e91e15/bmjopen-2018-022897f01.jpg

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