他汀类药物联合依泽替米贝治疗在减少促炎细胞因子方面是否是他汀类药物单药治疗的有益且等效的替代方案仍然未知。在本系统综述和荟萃分析中,我们旨在评估他汀类药物和依泽替米贝联合治疗对某些促炎细胞因子的影响.数据库,包括MEDLINE,SciVerse,Scopus,和ClarivateAnalyticsWebofScience数据库,直到2022年2月,都搜索了与他汀类药物和依泽替米贝和促炎细胞因子联合治疗相关的术语。使用Cochrane偏倚风险工具1评估纳入研究的质量,并使用加权平均差异[WMD]和变化的SD进行荟萃分析。结果表示为均值和95%CIs的差异,具有逆方差和随机效应模型。最后,12项研究[13组]被纳入定性和定量综合。患者平均年龄49.3-71岁,干预持续时间为7天至12个月.总的来说,我们的结果没有显示白细胞介素-1β(IL-1β)的任何显着降低(3项随机对照试验研究(RCTs),292名与会者,WMD:-0.4pg/ml;95%CI:-1.3,0.4,P=0.3,I2=93.1%,P<0.001),肿瘤坏死因子-α(TNF-α)(4个RCTs,199名参与者,WMD:-0.3pg/ml;95%CI:-0.8,0.1,P=0.1,I2=13.8%,P=0.3)和单核细胞趋化蛋白-1(MCP-1)(4个RCT,216名参与者,WMD:-7.8pg/ml;95%CI:-18.5,2.8,P=0.1,I2=30.8%,P=0.2)。然而,白细胞介素-6(IL-6)显着降低(9项RCTs,514名参与者,WMD:-1.4pg/ml;95%CI:-2.4,-0.3,P<0.007,I2=97.1%,P<0.001)和干扰素-γ(IFN-γ)(2个RCT,78人,WMD:-0.2pg/ml;95%CI:-0.4,-0.1,P<0.001,I2=0%,P=0.7)。在亚组分析之后,≥60岁年龄组和亚洲人群的IL-6显著降低.他汀类药物与依泽替米贝联合治疗可导致IL-6和IFN-γ显着降低,IL-6的减少在≥60岁和亚洲人群中显著。
It remains unknown whether statin therapy in combination with ezetimibe is a beneficial and equivalent alternative to statin monotherapy in reducing proinflammatory cytokines. In the present systematic
review and meta-analysis, we aimed to assess the effect of combination therapy with statins and ezetimibe on some proinflammatory cytokines. Databases, including MEDLINE, SciVerse, Scopus, and Clarivate Analytics Web of Science databases, were searched up to February 2022, for terms related to combination therapy with statins and ezetimibe and proinflammatory cytokines. The quality of the included studies was evaluated with Cochrane risk of bias tool 1, and weighted mean difference [WMD] and SD of changes were used for meta-analysis. The results were expressed as differences in means and 95 % CIs with an inverse variance and a random-effects model. Finally, 12 studies [13 arms] were included in the qualitative and quantitative synthesis. The average patient\'s age ranged from 49.3 to 71 years, and the duration of intervention lasted seven days to 12 months. Overall, our result did not show any significant reduction in interleukin-1beta (IL-1β) (3 randomized controlled trial studies (RCTs), 292 participants, WMD: -0.4 pg/ml; 95 % CI: -1.3, 0.4, P = 0.3, I2 = 93.1 %, P < 0.001), tumor necrosis factor-alpha (TNF-α) (4 RCTs, 199 participants, WMD: -0.3 pg/ml; 95 % CI: -0.8, 0.1, P = 0.1, I2 = 13.8 %, P = 0.3) and monocyte chemoattractant protein-1 (MCP-1) (4 RCTs, 216 participants, WMD: -7.8 pg/ml; 95 % CI: -18.5, 2.8, P = 0.1, I2 = 30.8 %, P = 0.2). However, there was a significant reduction in interleukin-6 (IL-6) (9 RCTs, 514 participants, WMD: -1.4 pg/ml; 95 % CI: -2.4, -0.3, P < 0.007, I2 = 97.1 %, P < 0.001) and interferon-gamma (IFN-γ) (2 RCTs, 78 participants, WMD: -0.2 pg/ml; 95 % CI: -0.4, -0.1, P < 0.001, I2 = 0 %, P = 0.7). Following subgroup analysis, there was a significant reduction in IL-6 in the age group ≥ 60 years and the Asian population. Statin therapy in combination with ezetimibe causes a significant decrease in IL-6 and IFN-γ, and the reduction in IL-6 is significant in ≥ 60 years and the Asian population.