Gan Lutong, Zhu Weiwen, Fu Pengqing
Department of Neurology, The Second Hospital of Guangzhou Medical School of China, Guangzhou, China.
Department of Cardiology, The Second Hospital of Guangzhou Medical School of China, Guangzhou, China.
Front Pediatr. 2023 Oct 9;11:1274972. doi: 10.3389/fped.2023.1274972. eCollection 2023.
Given the considerable discrepancies in the evidence concerning the efficacy of statins in ameliorating cognitive impairments in pediatric patients with Neurofibromatosis Type 1 (NF-1), this study conducts a systematic review and meta-analysis to consolidate existing evidence to evaluate the efficacy of statins on cognitive impairments in children with NF-1.
This study adhered to the PRISMA statement, and the research protocol was pre-registered on PROSPERO (#CRD: 42022369072). Comprehensive searches of databases including PubMed, Embase, and the Cochrane Library were performed up to March 31, 2023 to identify randomized controlled trials (RCTs) investigating the effects of statins on cognitive impairments in children with NF-1. Statistical analyses were conducted using Review Manager 5.4.1. A fixed- or random-effects model was employed according to the statistic. As all data were continuous, MD [95% CI] was used as the pooled estimate.
The final analysis included five RCTs with a total of 364 patients. The meta-analysis indicated that aside from a statistically significant improvement in internalizing problems (MD [95%CI] = 3.61[0.11, 7.10], = 0.04), Object assembly Test (MD [95%CI] = 0.53[0.12, 0.93], = 0.01), Cancellation Test (MD [95%CI] = 3.61[0.11, 7.10], < 0.0001), statins did not exhibit significant efficacy in improving other cognitive aspects in children with NF-1 (> 0.05). An additional descriptive analysis on indices that cannot be meta-analyzed revealed considerable inconsistency in the therapeutic effect of statins across different studies.
Current evidence suggests that statins may not be effective for cognitive performance in children with NF-1.
鉴于他汀类药物改善1型神经纤维瘤病（NF-1）儿科患者认知障碍疗效的证据存在相当大的差异，本研究进行了系统评价和荟萃分析，以整合现有证据，评估他汀类药物对NF-1儿童认知障碍的疗效。
本研究遵循PRISMA声明，研究方案已在PROSPERO（#CRD：42022369072）上预先注册。截至2023年3月31日，对包括PubMed、Embase和Cochrane图书馆在内的数据库进行了全面检索，以识别研究他汀类药物对NF-1儿童认知障碍影响的随机对照试验（RCT）。使用Review Manager 5.4.1进行统计分析。根据统计量采用固定效应或随机效应模型。由于所有数据均为连续性数据，MD[95%CI]用作合并估计值。
最终分析纳入了5项RCT，共364例患者。荟萃分析表明，除内化问题（MD[95%CI]=3.61[0.11，7.10]，P=0.04）、物体装配测试（MD[95%CI]=0.53[0.12，0.93]，P=0.01）、划消测试（MD[95%CI]=3.61[0.11，7.10]，P<0.0001）有统计学显著改善外，他汀类药物在改善NF-1儿童的其他认知方面未显示出显著疗效（P>0.05）。对无法进行荟萃分析的指标进行的额外描述性分析显示，不同研究中他汀类药物的治疗效果存在相当大的不一致性。
目前的证据表明，他汀类药物可能对NF-1儿童的认知表现无效。
