尿酸降低药物和肌肉损伤:系统性审查和网络元分析
Satoru Mitsuboshi1, Makoto Morizumi2, Kazumasa Kotake3
1Department of Pharmacy, Kaetsu Hospital, Niigata, Japan.
Journal of clinical pharmacology
|October 15, 2023
概括
这项研究发现,尿酸降低药物和安慰剂之间的肌肉损伤风险没有显著差异. 临床医生通常可以使用这些痛风药物,而不会增加对肌肉损伤的担忧.
科学领域:
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
- 临床流行病学临床流行病学
背景情况:
- 尿酸降低药物 (ULDs) 对于治疗痛风至关重要.
- 以前的报道表明,ULD和肌肉损伤之间存在潜在的联系.
- 关于这种关联的证据需要全面评估.
研究的目的:
- 调查口服尿酸降低药物与肌肉损伤风险之间的关联.
- 进行随机和非随机对照试验的网络元分析.
主要方法:
- 在MEDLINE,ClinicalTrials.gov和Cochrane中央注册表中进行系统搜索.
- 包括研究的主要结局是"所有肌肉损伤".
- 网络元分析使用随机效应模型来评估风险比率 (RR) 和置信区间 (CI).
主要成果:
- 分析了32项涉及28327名参与者的研究.
- 与安慰剂相比,没有发现Allopurinol,Febuxostat,Lesinurad,Lesinurad与Allopurinol,Lesinurad与Febuxostat或Topiroxostat的肌肉损伤风险有统计学意义的差异.
- 总体而言,偏差风险被认为是低至中等的.
结论:
- 在使用常见的尿酸降低药物时,肌肉损伤的风险似乎不是一个重大问题.
- 关于ULD的临床决定可能会在不担心肌肉损伤的情况下进行.
- 进一步的研究可能将重点放在特定患者群体或更罕见的不良事件上.
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