Peng Tzu-Rong, Yang Li-Jou, Wu Ta-Wei, Chao You-Chen
Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan.
School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei City 11031, Taiwan.
Medicina (Kaunas). 2020 Oct 1;56(10):513. doi: 10.3390/medicina56100513.
: The association between hypnotic drugs and risk of cancer remains controversial. Therefore, we performed a meta-analysis to investigate this association. : Pubmed and Embase were searched systematically to identify publications up to April 2020. The Newcastle-Ottawa scale for observational studies was used to assess the quality of studies. All included studies were evaluated by two reviewers independently; any discrepancies were resolved through discussion. Twenty-eight studies including 22 case-control studies and 6 cohort studies with 340,614 hypnotics users and 1,828,057 non-users were included in the final analyses. Hypnotics (benzodiazepines and Z-drugs) use was significantly associated with an increased risk of cancer (odds ratio [OR] or relative risk [RR] 1.17; 95% confidence interval 1.09-1.26) in a random-effects meta-analysis of all studies. Subgroup meta-analysis by anxiolytics/sedatives effect (anxiolytics benzodiazepines vs. sedatives group (include sedatives benzodiazepines and Z-drugs)) revealed that a significant association in sedatives group (pooled OR/RR 1.26, 95% CI, 1.10-1.45), whereas no significant relationship was observed in anxiolytics benzodiazepines (pooled OR/RR 1.09, 95% CI, 0.95-1.26). Moreover, a significant dose-response relationship was observed between the use of hypnotics and the risk of cancer. This meta-analysis revealed association between use of hypnotics drugs and risk of cancer. However, the use of lower dose hypnotics and shorter duration exposed to hypnotics seemed to be not associated with an increased risk of cancer. Moreover, the use of anxiolytics effect benzodiazepines seemed to be lower risk than sedatives benzodiazepines. A high heterogeneity was observed among identified studies, and results were inconsistent in some subgroups. Randomized control trials are needed to confirm the findings in the future.
催眠药物与癌症风险之间的关联仍存在争议。因此，我们进行了一项荟萃分析来研究这种关联。系统检索了PubMed和Embase以识别截至2020年4月的出版物。采用纽卡斯尔-渥太华观察性研究量表来评估研究质量。所有纳入研究均由两名评审员独立评估；任何差异均通过讨论解决。最终分析纳入了28项研究，包括22项病例对照研究和6项队列研究，涉及340,614名催眠药物使用者和1,828,057名非使用者。在所有研究的随机效应荟萃分析中，催眠药物（苯二氮䓬类和Z类药物）的使用与癌症风险增加显著相关（优势比[OR]或相对风险[RR]为1.17；95%置信区间为1.09 - 1.26）。按抗焦虑药/镇静剂效应进行的亚组荟萃分析（抗焦虑性苯二氮䓬类与镇静剂组（包括镇静性苯二氮䓬类和Z类药物））显示，镇静剂组存在显著关联（合并OR/RR为1.26，95%CI为1.10 - 1.45），而抗焦虑性苯二氮䓬类未观察到显著关系（合并OR/RR为1.09，95%CI为0.95 - 1.26）。此外，在催眠药物使用与癌症风险之间观察到显著的剂量反应关系。这项荟萃分析揭示了催眠药物使用与癌症风险之间的关联。然而，低剂量催眠药物的使用以及较短的催眠药物暴露时间似乎与癌症风险增加无关。此外，抗焦虑性苯二氮䓬类的使用风险似乎低于镇静性苯二氮䓬类。在已识别的研究中观察到高度异质性，并且在一些亚组中结果不一致。未来需要随机对照试验来证实这些发现。
