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BMJ:选择性5-羟色胺再摄取抑制剂联合他莫昔芬并不增加患者死亡的发生风险

2016-10-02 MedSci MedSci原创

本研究旨在对比女性中与单独使用他莫昔芬和选择性5-羟色胺再摄取抑制剂(SSRIs)——细胞色素P450 2D6酶(CYP2D6)的强效抑制剂,同时使用他莫昔芬和SSRIs治疗时死亡率的差异。 采用基于人口的队列研究,纳入五个美国的数据库,涵盖1995年至2013年注册个人和公共健康保险计划的人群。 两个队列中女性开始服用他莫昔芬。队列1中,在服用他莫昔芬时开始服用SSRI。队列2中,在

本研究旨在对比女性中与单独使用他莫昔芬和选择性5-羟色胺再摄取抑制剂(SSRIs)——细胞色素P450 2D6酶(CYP2D6)的强效抑制剂,同时使用他莫昔芬和SSRIs治疗时死亡率的差异。

采用基于人口的队列研究,纳入五个美国的数据库,涵盖1995年至2013年注册个人和公共健康保险计划的人群。

两个队列中女性开始服用他莫昔芬。队列1中,在服用他莫昔芬时开始服用SSRI。队列2中,在服用他莫昔芬之前研究对象已服用SSRI。

主要研究结果为每个队列中女性开始服用SSRIs与其他SSRIs治疗的全因死亡率。使用倾向得分来匹配暴露组。使用Cox回归模型来分别测定每个队列的结果和组合风险。

使用他莫昔芬治疗的队列1和队列2分别有6067个和8465名研究对象。平均年龄为55岁。中位随访时间2.2年(间距范围0.9-4.5)和2.0年(0.8-3.9)时,队列1和2分别有991和1014名患者死亡。与其他SSRIs相比,队列1和2的强效抑制剂的死亡汇总危险比为0.96(95%可信区间为0.88-1.06)。敏感性分析的结果是一致的。

总而言之,与其他SSRIs相比,使用他莫昔芬的同时使用CYP2D6抑制SSRIs与死亡的风险增加无关。

原始出处:

Macarius M Donneyong, et al., Risk of mortality with concomitant use of tamoxifen and selective serotonin reuptake inhibitors: multi-database cohort study. BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i5014.

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    2017-03-08 gaoxiaoe
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  5. 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  6. 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  8. 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  9. [GetPortalCommentsPageByObjectIdResponse(id=1922870, encodeId=caee19228e037, content=<a href='/topic/show?id=78f794e800a' target=_blank style='color:#2F92EE;'>#选择性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94780, encryptionId=78f794e800a, topicName=选择性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0802500050, createdName=肉我只吃一口, createdTime=Sat Feb 18 15:20:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1848116, encodeId=86bd18481165d, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, 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    2016-10-03 1e0d99ddm02(暂无匿称)

    了解一下!

    0

  10. 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    2016-10-03 1e0d99ddm02(暂无匿称)

    学习了,分享一下!

    0

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当前原位导管癌是通过切除,放射疗法,和辅助激素治疗的管理,通常使用他莫昔芬。研究人员推测,芳香酶抑制剂会更安全,更有效。因此,研究人员进行了这一试验,在绝经后性女性乳腺导管癌患者接受原位肿块切除术加放疗后,比较阿那曲唑与他莫昔芬的效果。

JCO:他莫昔芬加卵巢功能抑制治疗能更好控制乳腺癌

 最近发布的两项临床试验——他莫昔芬和依西美坦试验(TEXT)和卵巢功能抑制试验(SOFT)的临床结果为治疗绝经前有内分泌反应性早期乳腺癌的妇女提供了新的选择。SOFT试验中,他莫昔芬加上卵巢功能抑制(OFS)相对于单独使用他莫昔芬可以改善疾病控制,从而使得绝经前的妇女可以得到更好的化疗。SOFT试验的研究人员因此报道了由病人报告的疾病结局。为今后治疗这一类病人提供依据。 生活

JNCI:抗抑郁药是否会影响他莫昔芬治疗乳腺癌的有效性?

先前有研究表明他莫昔芬可降低乳腺癌复发风险,但是同时使用抗抑郁药物是否会干扰到他莫昔芬的有效性?就该问题目前并没有统一的答案。因此研究者进行了一项研究,调查同时服用他莫昔芬和抗抑郁药物(特别是帕罗西汀)是否会增加复发或对侧乳腺癌风险。该研究纳入了16887名0-Ⅱ期使用他莫昔芬治疗的乳腺癌生存者,以他莫昔芬和抗抑郁药物(帕罗西汀、氟西汀、其他选择性5-羟色胺再摄取抑制剂、三环类和其他)重叠百分比

J Clin Oncol:他莫昔芬对乳腺癌患者生存率的影响

目的本研究的目的是评估相比不规律治疗的乳腺癌患者而言,规律服用他莫昔芬2年的乳腺癌患者的治疗效果,并对她们进行长期随访和追踪调查(> 25年)。 方法564名绝经前出现原发性乳腺癌患者被随机分配到2组,实验组患者2年内规律服用他莫昔芬(N=276),对照组不接受系统性治疗(N=288)。 通过随访收集患者的总体死亡率(CM)和乳腺癌相关死亡率(CBCM)。平均随访时长为26.3年(22.7-

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