Lusitana Family Health Unit, Viseu, Portugal.
Faculty of Health Sciences, University of Beira Interior, Viseu, Portugal.
Pharmacoepidemiol Drug Saf. 2019 Nov;28(11):1431-1439. doi: 10.1002/pds.4895. Epub 2019 Sep 11.
Statins are widely prescribed drugs with established efficacy in primary and secondary prevention of cardiovascular events. Although they are mostly well tolerated, several authors have been emphasizing that the statins' safety profile is not totally clarified especially when considering risk of cancer in patients with long-term exposure to statins. This meta-analysis was aimed at evaluating the risk of cancer in patients with prolonged exposure to statins.
Medline, Cochrane library, and clinicaltrials.gov were searched in order to identify studies with a minimum average follow-up of 10 years of exposure to statins and a cancer-related outcome reported. Relative risk (RR) of the primary outcomes and the combined effect was presented using a random-effects model. In the selected randomized control trials (RCT), statin exposure was compared with placebo, and in the selected observational studies, it was compared with no exposure to statins.
We retrieved 1627 studies, of which 15 full-papers were included for final review, five RCT, two cohort studies (CSs), and eight case-control studies (CCs), representing a total of 358 544 patients. Five RCT, two cohort studies (CSs), and eight case-control studies (CCs). No significant differences were found regarding risk of cancer occurrence (RR = 1.08, 0.96-1.21) or cancer mortality (RR = 0.91, 0.80-1.04) due to long-term statin exposure. Regarding all-cause mortality, a protective effect was found (RR = 0.93, 0.90-0.97).
According to available and published evidence, statins are not associated with an increased risk of cancer after prolonged exposure. These findings strengthen the role of statins in the primary and secondary prevention of cardiovascular events.
他汀类药物是广泛应用的药物，在心血管事件的一级和二级预防中具有明确的疗效。虽然它们大多具有良好的耐受性，但有几位作者强调，他汀类药物的安全性概况尚未完全明确，尤其是考虑到长期暴露于他汀类药物的患者的癌症风险。本荟萃分析旨在评估长期暴露于他汀类药物的患者发生癌症的风险。
检索 Medline、Cochrane 图书馆和 clinicaltrials.gov，以确定暴露于他汀类药物至少 10 年且有癌症相关结局报告的研究。使用随机效应模型呈现主要结局和联合效应的相对风险（RR）。在入选的随机对照试验（RCT）中，他汀类药物暴露与安慰剂进行比较，而在入选的观察性研究中，与未暴露于他汀类药物进行比较。
我们检索到 1627 项研究，其中 15 篇全文纳入最终综述，包括 5 项 RCT、2 项队列研究（CSs）和 8 项病例对照研究（CCs），共纳入 358544 例患者。5 项 RCT、2 项 CS 和 8 项 CC。由于长期使用他汀类药物，未发现癌症发生风险（RR=1.08，0.96-1.21）或癌症死亡率（RR=0.91，0.80-1.04）的差异。对于全因死亡率，发现了一种保护作用（RR=0.93，0.90-0.97）。
根据现有和已发表的证据，长期使用他汀类药物不会增加癌症风险。这些发现强化了他汀类药物在心血管事件的一级和二级预防中的作用。
