氨基葡萄糖与骨关节炎的癌症发病率:新用户队列设计。

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-07-08 DOI:10.1002/acr.25399
Karine Suissa, Sophie Dell'Aniello, Eros Comin, Marie Hudson, Samy Suissa
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引用次数: 0

摘要

背景:观察性研究发现,用于治疗关节疼痛和骨关节炎的氨基葡萄糖与癌症发病率的降低有关,但其研究设计受到了选择偏倚的影响。我们采用一种可减轻这种选择偏差的研究设计来评估这种关联:我们利用英国临床实践研究数据链(UK Clinical Practice Research Datalink)确定了 1995-2017 年期间诊断为骨关节炎的患者队列。我们采用流行的新用户队列设计,根据时间条件倾向评分将氨基葡萄糖的初始使用者与非使用者进行匹配,并随访至癌症发生。通过估算癌症发病率的危险比(HR)和95%置信区间(CI)来比较氨基葡萄糖的使用和不使用情况:骨关节炎患者研究队列包括 20,541 名开始使用氨基葡萄糖的患者和 20,541 名未使用氨基葡萄糖的患者。在平均 8 年的随访期间,癌症总发病率为每年 16.4‰。使用氨基葡萄糖与不使用相比,任何癌症发病率的HR值为0.97(95% CI 0.91-1.02)。就肺癌而言,使用氨基葡萄糖的HR值为0.99(95% CI 0.83-1.18),而结肠直肠癌的HR值为1.11(95% CI 0.93-1.33),女性乳腺癌的HR值为1.07(95% CI 0.93-1.23),前列腺癌的HR值为1.03(95% CI 0.88-1.22):在这项针对骨关节炎患者的大型真实世界研究中,使用氨基葡萄糖治疗并没有降低癌症的发病率。这一发现进一步说明,以往的研究并非基于新用户,而是受到了选择偏差的影响。我们的研究不支持骨关节炎患者使用氨基葡萄糖预防癌症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Glucosamine and Cancer Incidence in Osteoarthritis: A Prevalent New-User Cohort Design

Objective

Observational studies have associated glucosamine, used to treat joint pain and osteoarthritis, with reductions in cancer incidence, although their study design was affected by selection bias. We assessed this association using a study design that mitigates this selection bias.

Methods

We used the UK Clinical Practice Research Datalink to identify a cohort of patients diagnosed with osteoarthritis during 1995 through 2017. The prevalent new-user cohort design was employed to match glucosamine initiators with non-users on time-conditional propensity scores, who were observed until cancer incidence. Hazard ratios (HRs) and 95% confidence intervals (CIs) of cancer incidence were estimated to compare glucosamine initiators with non-users.

Results

The study cohort of patients with osteoarthritis included 20,541 glucosamine initiators who were matched to 20,541 non-users. Over an average follow-up of eight years, the overall incidence rate of any cancer was 16.4 per 1,000 per year. The HR of any cancer incidence with glucosamine treatment was 0.97 (95% CI 0.91–1.02) compared with non-users. For lung cancer, the HR with glucosamine treatment was 0.99 (95% CI 0.83–1.18), whereas it was 1.11 (95% CI 0.93–1.33) for colorectal cancer, 1.07 (95% CI 0.93–1.23) for breast cancer in women, and 1.03 (95% CI 0.88–1.22) for prostate cancer.

Conclusion

In this large, real-world study of patients with osteoarthritis, designed to emulate a trial, treatment with glucosamine did not reduce the incidence of cancer. This finding reinforces that previous studies, not based on glucosamine initiators, were affected by selection bias. Our study does not support the prescription of glucosamine to prevent cancer in patients with osteoarthritis.

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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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