Medical research group of Egypt, Negida Academy, Arlington, Massachusetts, USA.
Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
CNS Neurosci Ther. 2024 Aug;30(8):e14888. doi: 10.1111/cns.14888.
Many observational studies have examined the association between statins and the incidence of Parkinson's disease (PD) in high-risk populations. On the other hand, clinical trials as well as other observational studies investigated the safety and efficacy of statins in slowing disease progression in PD patients. However, the evidence has been inconclusive in both questions. To that end, we conducted this systematic review and meta-analysis to synthesize evidence on the role of statins in decreasing the risk of PD among high-risk populations and as a possible disease-modifying agent for patients with PD.
A comprehensive literature search of electronic databases including PubMed, Scopus, Cochrane, and Web of Science has been performed. Relevant studies were chosen and data were extracted and analyzed using RevMan software version 5.4.1.
Twenty-five studies (14 cohort, 9 case-control, and 2 randomized controlled trials) have been included in the present systematic review. Of them, 21 studies reported the association between statins and PD risk. Statins were found to significantly reduce the risk of developing PD (pooled RR 0.86, 95% CI [0.77-0.95], p < 0.005). Four studies investigated statins as a disease-modifying agent. The pooled mean difference (MD) in the UPDRS-III from baseline to endpoint did not differ significantly between the statin and control groups (MD -1.34 points, 95% CI [-3.81 to 1.14], p = 0.29).
Although epidemiological observational studies showed that statin use was associated with a reduced risk of PD, current evidence is insufficient to support the role of statins in slowing the progression of PD. These findings are limited by the fact that most of the included studies are observational studies which carry a high risk of confounding bias which highlights the need for future well-designed RCTs.
许多观察性研究都考察了他汀类药物与高危人群中帕金森病（PD）发病率之间的关联。另一方面，临床试验以及其他观察性研究调查了他汀类药物在减缓 PD 患者疾病进展方面的安全性和有效性。然而，这两个问题的证据都没有定论。为此，我们进行了这项系统评价和荟萃分析，以综合评估他汀类药物在降低高危人群患 PD 风险以及作为 PD 患者可能的疾病修饰治疗药物方面的作用。
对包括 PubMed、Scopus、Cochrane 和 Web of Science 在内的电子数据库进行了全面的文献检索。选择相关研究，并使用 RevMan 软件版本 5.4.1 提取和分析数据。
本系统评价共纳入了 25 项研究（14 项队列研究、9 项病例对照研究和 2 项随机对照试验）。其中，21 项研究报告了他汀类药物与 PD 风险之间的关联。他汀类药物可显著降低 PD 的发病风险（汇总 RR 0.86，95%CI [0.77-0.95]，p<0.005）。有 4 项研究调查了他汀类药物作为疾病修饰治疗药物的作用。从基线到终点，UPDRS-III 的汇总平均差值（MD）在他汀类药物组和对照组之间没有显著差异（MD -1.34 分，95%CI [-3.81 至 1.14]，p=0.29）。
尽管流行病学观察性研究表明，他汀类药物的使用与降低 PD 风险相关，但目前的证据不足以支持他汀类药物在减缓 PD 进展方面的作用。这些发现受到限制，因为大多数纳入的研究都是观察性研究，存在较高的混杂偏倚风险，这突出表明需要进行未来设计良好的 RCT 研究。
