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他汀类药物的使用与多发性骨髓瘤风险降低相关:系统评价和荟萃分析。

Receipt of Statins Is Associated With Lower Risk of Multiple Myeloma: Systematic Review and Meta-analysis.

机构信息

Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Clin Lymphoma Myeloma Leuk. 2020 Jul;20(7):e399-e413. doi: 10.1016/j.clml.2020.02.011. Epub 2020 Feb 26.

Abstract

BACKGROUND

Studies on receipt of statins and risk of multiple myeloma (MM) yielded conflicting results. This systematic review and meta-analysis was conducted in order to comprehensively investigate the relationship between receipt of statins and risk of MM.

PATIENTS AND METHODS

Potentially eligible studies that compared the risk of MM between statin recipients and those who did not receive statins were identified from Medline and Embase databases from inception to August 2019 using a search strategy that comprised terms for "statin" and "multiple myeloma." To be eligible, cohort studies must have recruited 2 groups of participants, statin recipients and nonrecipients, and followed their participants for incident MM. Eligible case-control studies must have recruited cases of MM and controls without MM, and must have explored the history of receipt of statins. Relative risk, hazard risk ratio, standardized incidence ratio, or odds ratio (OR) of this association must be reported. Relative risk and standard error from each study were extracted and combined using random-effect generic inverse variance. Relative risk of cohort study was used as an estimate for OR to calculate the pooled effect estimate along with the OR of the case-control studies.

RESULTS

A total of 1744 articles were identified using the search strategy, and 10 studies were included in the meta-analysis. The odds of MM were significantly lower among statin recipients than nonrecipients, with a pooled OR of 0.80 (95% confidence interval, 0.68-0.93; I 72%). The funnel plot was relatively symmetrical and did not suggest publication bias.

CONCLUSION

Receipt of statins is associated with a significant 20% reduction in the odds of MM.

摘要

背景

关于他汀类药物的使用与多发性骨髓瘤(MM)风险的研究结果存在争议。本系统评价和荟萃分析旨在全面研究他汀类药物的使用与 MM 风险之间的关系。

患者和方法

从 Medline 和 Embase 数据库中,通过包含“他汀类药物”和“多发性骨髓瘤”的检索策略,检索了截至 2019 年 8 月间发表的比较他汀类药物使用者与未使用者发生 MM 风险的潜在合格研究。合格的队列研究必须招募了两组参与者,他汀类药物使用者和未使用者,并对其参与者进行了 MM 的发病情况随访。合格的病例对照研究必须招募了 MM 病例和无 MM 的对照,并必须探讨了他汀类药物使用史。必须报告该相关性的相对风险、风险比、标准化发病比或比值比(OR)。从每项研究中提取相对风险和标准误差,并使用随机效应通用倒数方差法进行合并。使用队列研究的相对风险作为 OR 的估计值,计算合并效应估计值以及病例对照研究的 OR。

结果

使用检索策略共确定了 1744 篇文章,其中 10 项研究纳入荟萃分析。他汀类药物使用者发生 MM 的可能性明显低于未使用者,合并 OR 为 0.80(95%置信区间,0.68-0.93;I 72%)。漏斗图相对对称,未提示存在发表偏倚。

结论

他汀类药物的使用与 MM 风险降低 20%显著相关。

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