他汀类药物作为帕金森病潜在的疾病修饰疗法：一项采用序贯试验分析的系统评价和荟萃分析

Statins as potential disease-modifying therapy of Parkinson's disease: a systematic review and meta-analysis with trial sequential analysis.

作者信息

Gonçalves Ocílio Ribeiro, Nascimento Arquimedes Barros, Soares Victor Gonçalves, Abraham David, de Almeida Monteiro Gabriel, Freitas João Luís Reis, da Cunha Monteiro Ribeiro Jonatas Paulino, Ribeiro Bianca Leal, de Oliveira João Victor Araújo, Dos Santos Marco Antonnio Rocha, Telles João Paulo Mota, Sekeff-Sallem Flávio, Almeida Kelson James

机构信息

Federal University of Piauí, Teresina, PI, Brazil.

Federal University of Vales Do Jequitinhonha and Mucuri, Diamantina, MG, Brazil.

出版信息

Acta Neurol Belg. 2024 Dec 30. doi: 10.1007/s13760-024-02709-4.

DOI:10.1007/s13760-024-02709-4

PMID:39738967

Abstract

BACKGROUND

Recent evidence indicates that statins have anti-inflammatory and antioxidant effects, leading to several investigations of whether statins have a neuroprotective effect and may benefit patients with Parkinson's disease (PD). However, the potential mechanisms of this class of medications as modifiers of the course of PD in already diagnosed patients is still unclear.

OBJECTIVES

To assess the effectiveness of statins as modifiers of established PD.

METHODS

Two investigators systematically searched for randomized clinical trials and observational studies comparing PD patients treated with statins versus those treated without statins. The search was conducted in PubMed, Embase, Cochrane, and Web of Science. The outcome of interest was the change in the MDS-UPDRS III (Movement Disorder society-Unified Parkinson's Disease Rating Scale Part III) and UPDRS III scores from baseline. Statistical analysis was performed using R Studio 4.3.2.

RESULTS

Four studies, totaling 472 patients, were included. The standardized mean difference for the MDS-UPDRS Part III and UPDRS Part III scales between statin and non-statin groups was - 0.13 (95% CI - 0.44 to 0.17; p = 0.39; I = 58%), and there was no statistical significant difference regarding this outcome.

CONCLUSION

There was no statistical significance for the potential clinical benefit of statins as modifiers of the disease course in PD patients.

摘要

背景

最近的证据表明，他汀类药物具有抗炎和抗氧化作用，引发了多项关于他汀类药物是否具有神经保护作用以及是否可能使帕金森病（PD）患者受益的研究。然而，在已确诊的患者中，这类药物作为PD病程调节剂的潜在机制仍不清楚。

目的

评估他汀类药物作为已确诊PD病程调节剂的有效性。

方法

两名研究人员系统检索了比较接受他汀类药物治疗的PD患者与未接受他汀类药物治疗的患者的随机临床试验和观察性研究。检索在PubMed、Embase、Cochrane和Web of Science中进行。感兴趣的结局是MDS-UPDRS III（运动障碍协会统一帕金森病评定量表第三部分）和UPDRS III评分相对于基线的变化。使用R Studio 4.3.2进行统计分析。