关于他类药物相关肌肉症状的药物遗传学的出版偏差:一项超流行病学研究
A Gougeon1, I Aribi2, S Guernouche3
1Laboratoire de Biométrie et Biologie Evolutive UMR CNRS 5558, Université Lyon 1, Université de Lyon, Villeurbanne, France; RCTs, Lyon, France.
Atherosclerosis
|November 2, 2024
概括
发表偏见可能会高估SLCO1B1基因型与他类药物相关肌肉症状 (SAMS) 之间的联系. 纠正这种偏差显示没有显著的关联,可能防止不必要的他类药物剂量减少.
科学领域:
- 药物遗传学 药物遗传学
- 临床药理学 临床药理学
- 生物统计学 生物统计学
背景情况:
- 类他类药物相关的肌肉症状 (SAMS) 经常导致停止治疗.
- 临床药物遗传学实施联盟 (CPIC) 的指导方针建议以SLCO1B1基因型为指导的他类药物剂量来减轻SAMS.
- 发表偏见可能会扭曲SLCO1B1基因型与SAMS之间的估计关联.
研究的目的:
- 评估出版偏差对SLCO1B1基因型与SAMS之间的关联的影响.
- 在使用强大的统计方法纠正出版偏差后,重新评估关联.
主要方法:
- 对SLCO1B1基因型和SAMS.发表的研究进行系统审查.
- 使用漏斗图,埃格尔测试和强大的贝叶斯元分析 (RoBMA) 的出版偏差评估.
- 未经纠正的赔率比率 (OR未经纠正) 与偏差纠正的估计 (ORTrim&Fill,ORRoBMA) 的比较.
主要成果:
- 分析包括19项研究 (8个队列,11个病例控制) 具有62个概率比率.
- 发现了出版偏差 (Egger的p=0.001,RoBMA BF出版偏差=18).
- 偏差校正消除了显著的关联:OR未纠正的 (1.31) 与ORTrim&Fill (1.07) 和ORRoBMA (1.02).
结论:
- 在文献中,SLCO1B1基因型与SAMS风险之间的关联可能被高估了.
- 具体来说,rs4149056变种的影响似乎被夸大了.
- 过高估计可能导致不适当的他类药物剂量减少,可能会损害心血管益处.
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