Wang Miao, Li Muqin, Xie Ying
Department of Endocrinology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
J Clin Pharm Ther. 2021 Aug;46(4):1046-1054. doi: 10.1111/jcpt.13393. Epub 2021 Feb 25.
Statins are widely used lipid-lowering drugs and play an important role in the treatment of many cardiovascular diseases. With the increase in the scope of use and the number of users, peripheral neuropathy caused by statins has been frequently reported. There are no randomized controlled trials comparing the relationship between statins and the risk of peripheral neuropathy. Therefore, we systematically reviewed and meta-analysed observational studies evaluating the impact of statins on the risk of peripheral neuropathy.
PubMed, Embase, the Cochrane Library databases and Web of Science were used to search the effects of statins on polyneuropathy from inception to 3 December 2020. We included studies that met the following criteria: (i) A randomized controlled trial, prospective or retrospective cohort study examining the relationship between statins and peripheral neuropathy (PN). Exclusion criteria included the following: Reviews and research related to other diseases or subjects; and studies without data on the prevalence of PN were excluded. Newcastle-Ottawa scale (NOS) was used for quality assessment of included studies. Meta-analysis was used to estimate the risk of disease. We conducted a subgroup analysis of duration of follow-up, adjusted (adjusted RR vs. unadjusted RR), sample size, study design and region.
A total of 9 independent studies assessing 150 556 patients were included in this analysis. In this meta-analysis, we found that there was a nonsignificant increase of PN with statins exposure (RR 1.26, 95% CI (0.92-1.74)). Our results revealed that there was no significant association between statins exposure and peripheral neuropathy risk.
Statins exposure does not influence the risk of developing peripheral neuropathy. The quality of the evidence included in this study is low, but it can provide useful information for clinicians.
他汀类药物是广泛使用的降脂药物，在多种心血管疾病的治疗中发挥着重要作用。随着使用范围和使用人数的增加，他汀类药物引起的周围神经病变屡有报道。目前尚无比较他汀类药物与周围神经病变风险之间关系的随机对照试验。因此，我们对评估他汀类药物对周围神经病变风险影响的观察性研究进行了系统综述和荟萃分析。
使用PubMed、Embase、Cochrane图书馆数据库和Web of Science检索从起始至2020年12月3日他汀类药物对多发性神经病变的影响。我们纳入了符合以下标准的研究：（i）一项随机对照试验、前瞻性或回顾性队列研究，考察他汀类药物与周围神经病变（PN）之间的关系。排除标准包括：与其他疾病或主题相关的综述和研究；以及无PN患病率数据的研究。采用纽卡斯尔-渥太华量表（NOS）对纳入研究进行质量评估。使用荟萃分析估计疾病风险。我们对随访时间、调整情况（调整后的RR与未调整的RR）、样本量、研究设计和地区进行了亚组分析。
本分析共纳入9项评估150556例患者的独立研究。在这项荟萃分析中，我们发现他汀类药物暴露使PN有非显著性增加（RR 1.26，95%CI（0.92 - 1.74））。我们的结果显示，他汀类药物暴露与周围神经病变风险之间无显著关联。
他汀类药物暴露不影响发生周围神经病变的风险。本研究纳入证据的质量较低，但可为临床医生提供有用信息。
