Department of Pharmacy, General Hospital of Central Theater Command, Wuhan 430010, China.
Department of Clinical Pharmacy, General Hospital of Central Theater Command, Wuhan 430010, China.
Exp Gerontol. 2024 Nov;197:112587. doi: 10.1016/j.exger.2024.112587. Epub 2024 Oct 11.
Tamoxifen has been used in the management of breast cancer. The available evidence on the effect of tamoxifen on lipoprotein(a) and apolipoproteins is controversial. Hence, this meta-analysis of randomized controlled trials (RCTs) was conducted to increase the quality of evidence on the effect of tamoxifen on lipoprotein(a) and apolipoproteins.
Eligible RCTs published up to September 2023 were carefully selected following a comprehensive search. Thereafter, a meta-analysis was conducted using a random-effects model and the results were presented as the weighted mean difference (WMD) with a 95 % confidence interval (CI).
The results from the random-effects model indicated a rise in ApoA-I (WMD: 16.24 mg/dL, 95 % CI: 5.35, 27.12, P = 0.003), and a decrease in ApoB (WMD: -9.37 mg/dL, 95 % CI: -15.16, -3.59, P = 0.001) and lipoprotein(a) (WMD: -3.24 mg/dL, 95 % CI: -5.66, -0.83, P < 0.001) concentrations following tamoxifen administration in women. Furthermore, a more pronounced decrease in ApoB (WMD: -12.86 mg/dL, 95 % CI: -19.78, -5.93, P < 0.001) and elevation in ApoA-1 levels (WMD: 51.97 mg/dL, 95 % CI: 45.89, 58.05, P < 0.001) were identified in a single study on patients with breast cancer.
The current meta-analysis demonstrated an increase of ApoA-I and a decrease of ApoB and lipoprotein(a) levels after treatment with tamoxifen in women.
他莫昔芬被用于乳腺癌的治疗。关于他莫昔芬对脂蛋白（a）和载脂蛋白的影响，现有证据存在争议。因此，本荟萃分析纳入了随机对照试验（RCTs），旨在提高关于他莫昔芬对脂蛋白（a）和载脂蛋白影响的证据质量。
全面检索后，精心筛选了截至 2023 年 9 月发表的合格 RCTs。然后，使用随机效应模型进行荟萃分析，并以加权均数差值（WMD）及其 95%置信区间（CI）呈现结果。
随机效应模型的结果表明，ApoA-I 水平升高（WMD：16.24mg/dL，95%CI：5.35，27.12，P=0.003），ApoB（WMD：-9.37mg/dL，95%CI：-15.16，-3.59，P=0.001）和脂蛋白（a）（WMD：-3.24mg/dL，95%CI：-5.66，-0.83，P<0.001）浓度降低，提示他莫昔芬治疗后女性的这些指标发生了变化。此外，一项关于乳腺癌患者的单中心研究发现，ApoB 降低更为明显（WMD：-12.86mg/dL，95%CI：-19.78，-5.93，P<0.001），ApoA-1 水平升高（WMD：51.97mg/dL，95%CI：45.89，58.05，P<0.001）。
本荟萃分析表明，女性接受他莫昔芬治疗后，ApoA-I 水平升高，ApoB 和脂蛋白（a）水平降低。
