抗雄激素剥夺疗法和痴呆风险:更新的和剂量-反应元分析
Shun Zhu1,2, Jingnian Ni2, Siwei Long1,2
1Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Journal of Alzheimer's disease : JAD
|February 17, 2025
概括
抗雄激素剥夺疗法 (ADT) 与痴呆症,特别是阿尔茨海默病 (AD) 的风险更高有关. 该研究发现ADT持续时间和痴呆症风险之间存在非线性,钟形关系.
科学领域:
- 神经学 神经学
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
背景情况:
- 人们还在讨论安德روج因剥夺疗法 (ADT) 与痴呆风险之间的关联.
- 在ADT和痴呆风险之间缺乏明确的剂量反应关系.
研究的目的:
- 为了澄清ADT和痴呆风险之间的关系.
- 为了研究ADT持续时间和痴呆症风险之间的剂量反应关系.
主要方法:
- 在PubMed,科学网,Embase和Cochrane图书馆进行系统的文献搜索,截至2024年9月.
- 对21项研究 (2,278,835名患者) 的元分析,使用危险比率 (HR) 和95%置信区间 (CI).
- 强大的误差元回归 (REMR) 用于剂量反应分析,并进行子组和灵敏度分析.
主要成果:
- ADT显著增加了整体痴呆风险 (HR=1.14) 和阿尔茨海默病 (AD) 风险 (HR=1.15).
- 抗雄激素药物显示痴呆症风险增加 (整体HR=1.27,ADHR=1.53),不同于LHRH治疗或管切除术.
- 观察到一个钟形的非线性剂量反应曲线,最高风险在ADT15.5-21.5个月之间.
结论:
- ADT与痴呆症和AD风险的增加显著相关.
- 在ADT持续时间和痴呆症风险之间存在钟形剂量反应效应.
- 与其他ADT类型相比,抗雄激素治疗对痴呆的风险更高.
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