脂質修飾療法と炎のリスク:メタ分析
David Preiss1, Matti J Tikkanen, Paul Welsh
1BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Pl, Glasgow G12 8TA, United Kingdom. david.preiss@glasgow.ac.uk
JAMA
|August 23, 2012
まとめ
スタチンの治療は,正常またはわずかにトリグリセリド値が上昇した患者の炎のリスク低下と関連していました. しかし,繊維酸療法では,炎のリスクが潜在的に増加することが示されました.
科学分野:
- 心血管医学は,心臓血管医学である.
- 薬理学 薬理学とは
- クリニック・トライアル 臨床試験
背景:
- 観察研究は,スタチン療法が臓炎と関連している可能性があることを示唆しています.
- 脂質ガイドラインは,炎のリスクを軽減するために,高トリグリセリデミアのための繊維酸を推奨しますが,繊維酸は炎の危険因子である胆石を引き起こす可能性があります.
研究 の 目的:
- 大規模なランダム化対照試験のデータを用いて,スタチンまたはファイブレート療法と炎の発生率の関連性を調査する.
主な方法:
- 関連するランダム化対照試験について,MEDLINE,EMBASE,Web of Scienceの体系的な文献検索が行われました.
- 21件のスタチン試験 (153,414人の参加者) と7件のフィブラート試験 (40,162人の参加者) のデータは,ランダム効果メタ解析を用いてまとめた.
主要な成果:
- スタチンの治療は,炎のリスクの低下と関連していた (リスク比 (RR),0.79;95%CI,0.65-0.95).
- 線維治療は,炎のリスクの増加に向けた傾向を示した (RR, 1.39; 95% CI, 1.00-1.95).
結論:
- ランダム化試験データのプール分析により,スタチンの使用は,トリグリセリド濃度が正常またはわずかに上昇した患者において,炎のリスクが低いとの関連があることが示されています.
- 線維治療は,炎のリスクの増加と関連している可能性があります.
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