多发性硬化症（MS）患者接受芬戈莫德治疗后的癌症发病率：系统评价和荟萃分析。
Incidence of cancer in patients with multiple sclerosis (MS) who were treated with fingolimod: A systematic review and meta-analysis.
机构信息
Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
出版信息
Mult Scler Relat Disord. 2022 Mar;59:103680. doi: 10.1016/j.msard.2022.103680. Epub 2022 Feb 9.
BACKGROUND
Fingolimod is a sphingosine-1-phosphate-receptor modulator that is used for the relapsing form of MS. There are controversial reports regarding the incidence of cancer in patients with MS who were treated with fingolimod. Therefore, we designed this systematic review and meta-analysis to estimate the pooled incidence of cancer in patients with MS who were treated with various dose of fingolimod.
METHOD
Two expert researchers searched systematically PubMed, Scopus, EMBASE, Web of Science, and google scholar as well as references of the included studies, and conference abstracts which were published up to November 2021.
RESULTS
We found 5231 articles by literature search, after deleting duplicates 3070 remained. Thirty-four articles remained for meta-analysis. Totally, 64,135 patients with MS who received fingolimod were enrolled. The total number of patients with cancer was 2561. The pooled incidence of cancer in patients with MS who received fingolimod was 2.02% (95% CI:2.00-3.01%, I = 97.8%, P < 0.001). The pooled incidence of cancer in group who received 0.5 mg was 2.01%(95%CI:1.00-2.04%) (I = 91.7%, P < 0.001). The pooled incidence of cancer in the group that received 1.25 mg was 3.01%(95%CI:2.02-5.01%) (I = 67.5%, P < 0.001).
CONCLUSION
The result of this systematic review and meta-analysis shows that the pooled prevalence of cancer in MS patients who received fingolimod was 2%. The risk of cancer is higher in patients with MS who received 1.25 mg fingolimod 1.25 mg than cases who received 0.5 mg.
背景
芬戈莫德是一种鞘氨醇-1-磷酸受体调节剂，用于治疗多发性硬化症的复发形式。有争议的报告称，接受芬戈莫德治疗的多发性硬化症患者的癌症发病率。因此，我们设计了这项系统评价和荟萃分析，以估计接受不同剂量芬戈莫德治疗的多发性硬化症患者的癌症总发病率。
方法
两名专家研究人员系统地搜索了 PubMed、Scopus、EMBASE、Web of Science 和谷歌学术以及纳入研究的参考文献和会议摘要，这些文献均截至 2021 年 11 月发表。
结果
通过文献检索共找到 5231 篇文章，删除重复项后保留 3070 篇。34 篇文章用于荟萃分析。共有 64135 名接受芬戈莫德治疗的多发性硬化症患者被纳入。癌症患者总数为 2561 例。接受芬戈莫德治疗的多发性硬化症患者的癌症总发病率为 2.02%（95%CI：2.00-3.01%，I = 97.8%，P<0.001）。接受 0.5mg 组的癌症发病率为 2.01%（95%CI：1.00-2.04%）（I = 91.7%，P<0.001）。接受 1.25mg 组的癌症发病率为 3.01%（95%CI：2.02-5.01%）（I = 67.5%，P<0.001）。
结论
本系统评价和荟萃分析的结果表明，接受芬戈莫德治疗的多发性硬化症患者的癌症总患病率为 2%。与接受 0.5mg 芬戈莫德治疗的病例相比，接受 1.25mg 芬戈莫德治疗的多发性硬化症患者的癌症风险更高。
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