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【Diabetes Care】罗格列酮与发生肿瘤的风险（Met
A meta-analysis of randomized clinical trials
ABSTRACT
OBJECTIVE—Despite experimental data suggesting a protective effect of peroxisome proliferator–activated receptor- agonists with respect to malignancies, results of available epidemiological studies on the incidence of cancer in rosiglitazone-treated patients are not univocal. The aim of this meta-analysis of randomized clinical trials is to assess the effect of rosiglitazone on the incidence of cancer.
RESEARCH DESIGN AND METHODS—Randomized clinical trials of rosiglitazone with duration of >24 weeks were retrieved through Medline and from the GlaxoSmithKline Web site, which reports main results of all trials sponsored by GlaxoSmithKline; incident malignancies were retrieved from the summary of serious adverse events. Proportions of outcome measures across treatment groups were compared by odds ratios (ORs) and 95% CI. Considering differences in the duration of follow-up among treatment arms in some of the trials, we also calculated the incidence of cancer in rosiglitazone and control groups.
RESULTS—Eighty trials, enrolling 16,332 and 12,522 patients in the rosiglitazone and comparator groups, respectively, were retrieved. Rosiglitazone was not associated with a significant modification of the risk of cancer (OR 0.91 [95% CI 0.71–1.16], P = 0.44). The incidence of malignancies was significantly lower in rosiglitazone-treated patients than in control groups (0.23 [0.19–0.26] vs. 0.44 [0.34–0.58] cases/100 patient-years; P < 0.05).
CONCLUSIONS—The use of rosiglitazone appears to be safe in terms of incidence of cancer, whereas its possible protective effect needs to be further investigated.
1455.pdf (137.81k) 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Rosiglitazone and Risk of Cancer
A meta-analysis of randomized clinical trials
罗格列酮和肿瘤的风险
对随机临床试验的荟萃分析
ABSTRACT
摘要
OBJECTIVE—Despite experimental data suggesting a protective effect of peroxisome proliferator–activated receptor- agonists with respect to malignancies, results of available epidemiological studies on the incidence of cancer in rosiglitazone-treated patients are not univocal. 很惭愧，当时发贴的时候没有细看摘要内容，所以就写了“罗格列酮引发肿瘤”。其实这篇文章并不是主要讲这个的。
说些题外话，
这篇文章让我想起当年做课题的时候看的两篇文献，关于垂体肿瘤的药物治疗，这个group（在UCLA）发现PPAR-gama激动剂对Cushing's Disease有一定的治疗作用：
1: Heaney AP, Fernando M, Melmed S.
PPAR-gamma receptor ligands: novel therapy for pituitary adenomas.
J Clin Invest. 2003 May;111(9):1381-8.
PMID: 12727930
2: Heaney AP, Fernando M, Yong WH, Melmed S.
Functional PPAR-gamma receptor is a novel therapeutic target for ACTH-secreting pituitary adenomas.
Nat Med. 2002 Nov;8(11):1281-7.
可是既然发表了这两篇重量级（IF很高）的文章，怎么这几年没有后续文章了呢？
这个group就跟得蛮紧，呵呵：
Gruszka A, Kunert-Radek J, Pawlikowski M.
Rosiglitazone, PPAR-gamma receptor ligand, decreases the viability of rat prolactin-secreting pituitary tumor cells in vitro.
Neuro Endocrinol Lett. 2005 Feb;26(1):51-4.
PMID: 15726020
但也有一篇文献干脆说这个东东压根儿没用：
Suri D, Weiss RE.
Effect of pioglitazone on adrenocorticotropic hormone and cortisol secretion in Cushing's disease.
J Clin Endocrinol Metab. 2005 Mar;90(3):1340-6.
PMID: 15585550
所以说这个东西看着好，其实未必就非常管用。而且不同的肿瘤发生机制差异很大，如果一个PPAR就能对它们都有保护作用，那倒反而奇怪了。（私下里问过一个英国伯明翰大学的教授，他对用这个玩意儿治疗垂体肿瘤就表示摇头）
其他肿瘤偶就不太懂了哈，但是药物在临床应用与在实验室给那些做了手脚的老鼠、细胞使用的效果肯定是有很大差别的。所以说有那么多振奋人心的实验室发现最终在临床上得不到验证。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-09-02 17:14
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