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Las estatinas y el riesgo de cáncer: un metanálisis
Krista M Dale1, Craig I Coleman, Nickole N Henyan
1University of Connecticut School of Pharmacy, Storrs, Conn, USA.
JAMA
|January 5, 2006
Resumen
Las estatinas, utilizadas para bajar el colesterol, no parecen prevenir el cáncer o reducir las muertes por cáncer en base a una revisión de ensayos controlados aleatorios. Este efecto neutro se observó en todos los tipos de cáncer y subtipos de estatinas.
Área de la Ciencia:
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Oncología Oncología.
- Farmacología Farmacología.
Sus antecedentes:
- Las estatinas son medicamentos para reducir el colesterol ampliamente prescritos con beneficios establecidos en la prevención de eventos cardíacos.
- La evidencia emergente de estudios retrospectivos sugirió un papel potencial para las estatinas en la prevención del cáncer.
Objetivo del estudio:
- Evaluar sistemáticamente el impacto de la terapia con estatinas en la incidencia y la mortalidad por cáncer.
- Para analizar los efectos de las estatinas en tipos específicos de cáncer y diferentes formulaciones de estatinas (lipofílico vs. hidrófilo, natural vs. sintético).
Principales métodos:
- Se realizó una búsqueda exhaustiva de la literatura en múltiples bases de datos (MEDLINE, EMBASE, etc.) hasta julio de 2005.
- Se incluyeron datos de 26 ensayos controlados aleatorios (ECA) que involucraron a 86.936 participantes, centrándose en la incidencia y muerte por cáncer.
- Los metanálisis se realizaron utilizando modelos de efectos aleatorios para calcular las proporciones de probabilidad (OR) y los intervalos de confianza del 95% (IC).
Principales resultados:
- Los metanálisis de 6662 casos de cáncer incidentes y 2407 muertes por cáncer no revelaron una reducción significativa en la incidencia del cáncer (OR, 1.02; IC del 95%, 0.97-1.07) o la mortalidad por cáncer (OR, 1.01; IC del 95%, 0.93-1.09) con el uso de estatinas.
- Ningún tipo específico de cáncer mostró una reducción en la incidencia o mortalidad.
- Este efecto neutro fue consistente en todas las estatinas hidrófilas, lipofílicas, de origen natural y sintéticas.
Conclusiones:
- Los ensayos controlados aleatorios indican que las estatinas tienen un efecto neutro sobre el riesgo de desarrollar cáncer y la muerte relacionada con el cáncer.
- La terapia con estatinas no parece influir en la incidencia o mortalidad de ningún tipo específico de cáncer.
- Los diferentes subtipos de estatinas tampoco demostraron ningún impacto en el riesgo de cáncer.
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