抗甲状腺药物和剂量风险平衡:对甲状腺功能障碍症中亚核细胞瘤的元分析
Luis Agustín Ramírez Stieben1,2,3, Lucas Ricardo Brun4,5, Paula Nasazzi Doddi6
1Department of Thyroid and Parathyroid, Grupo Gamma, Rosario, Argentina. ramirez.stieben@gmail.com.
这项研究发现甲基甲状腺功能障碍症中甲基马 (MMI) 和propylthiouracil (PTU) 之间的农细胞瘤发生风险没有差异. 然而,较高的MMI剂量 (≥30 mg/天) 显著增加了这种罕见但严重的不良反应.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 甲状腺细胞瘤是抗甲状腺药物 (ATD) 的严重不良影响.
- 甲基马 (MMI) 与甲 (PTU) 之间的比较风险以及MMI的剂量依赖风险尚未完全理解.
研究的目的:
- 评估MMI和PTU的农细胞瘤发生率和相对风险.
- 为了确定更高的MMI剂量是否与增加的农细胞瘤的风险有关.
主要方法:
- 13项临床研究的系统审查和元分析.
- 在MEDLINE,科克伦图书馆和LILACS搜索到2025年3月.
- 使用RoB 2.0和ROBINS-I评估偏差风险;使用随机效应模型进行元分析.
主要成果:
- 在MMI和PTU (OR = 0.87) 之间没有显著的差异在农细胞瘤的风险.
- 较高的MMI剂量 (≥30毫克/天) 与较低的剂量 (<30毫克/天) (OR = 0.34) 相比,显示出明显增加的风险.
- 在随机对照试验和回顾性研究中观察到较低的发病率.
结论:
- 在MMI和PTU之间没有显著的差异在农细胞瘤的风险.
- 较高的MMI剂量 (≥30 mg/天) 与风险增加有关.
- 建议使用最低有效的MMI剂量,并强调严格的研究方法.
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