他汀类药物提高抗病毒药物治疗慢性丙型肝炎疗效的系统评价

Statin therapy improves response to anti-HCV drugs in chronic hepatitis C: A systematic review and Meta-analysis

目的:评价他汀类药物对抗病毒治疗慢性丙型肝炎疗效的影响。方法:检索PubMed,EMBASE,Cochrane Library,万方数据库,中国知网数据库中有关他汀类药物与慢性丙型肝炎抗病毒治疗的临床研究。结果:5项RCTs和4项临床观察共计1 020例患者纳入本研究。RCTs研究显示:他汀类药物可提高干扰素联合利巴韦林的持续病毒应答率(sustained virological response,SVR;58.1%vs38.8%,OR=2.26,95%CI 1.75~3.79,P=0.002),不能提高直接抗病毒药物(direct-acting antiviral agents,DAA)的SVR(OR=0.78,95%CI 0.30~2.07;P=0.62)。观察性研究显示:他汀类药物可提高干扰素联合利巴韦林对HCV基因I型的SVR(65.3%vs 41.9%,OR=2.70,95%CI 1.71~4.27,P<0.001),对HCV基因2型或3型无作用(83.8%vs 86.1%,OR=0.91,95%CI 0.42~1.97,P=0.81)。结论:他汀类药物可提高干扰素联合利巴韦林治疗慢性丙型肝炎的SVR,尤其对基因1型HCV患者的作用明显;对DAA抗HCV无明显作用。

Objective： To evaluate the efficacy and safety of statins combine with anti-HCV drugs in chronic hepatitis C.Methods： The clinical studies on statin and anti-HCV drugs in chronic hepatitis C were searched in PubMed,EMBASE, Cochrane Library, and Wanfang Database, the Chinese Biomedical Database. Results： A total of1 020 participants in 5 randomized controlled trials（RCTs） and 4 prospective observational studies were enrolled.RCTs showed that statin therapy can improve sustained virological response（SVR） to interferon alfa and ribavirin in chronic hepatitis C（58.1% vs 38.8%, OR=2.26, 95% CI 1.75–3.79, P=0.002）, while statin therapy can not improve SVR to direct acting antivirals（DAA） in chronic hepatitis C（OR=0.78, 95% CI 0.30–2.07, P=0.62）.The observational studies found that statin therapy can improve SVR to interferon alfa and ribavirin in hepatitis Cgenotype 1（65.3% vs 41.9%, OR=2.70, 95% CI 1.71–4.27, P0.0001）; however, statin therapy cannot improve SVR to interferon alfa and ribavirin in hepatitis C genotype 2 or 3（83.8% vs 86.1%, OR=0.91; 95% CI 0.42–1.97;P=0.81）. Conclusion： Statin therapy can improve SVR to interferon alfa and ribavirin in hepatitis C genotype 1, it cannot improve SVR to DAA in chronic hepatitis C.