Association between antidepressant use and gynecological cancer risk: a systematic review and meta-analysis.

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-05-29 DOI:10.1007/s00228-025-03853-3

Francisco Cezar Aquino de Moraes, Pedro Henrique de Souza Wagner, Luana Izabela Azevedo de Carvalho, Rommel Mario Rodríguez Burbano

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引用次数: 0

Abstract

Purpose: The potential carcinogenic effects of antidepressants (ADs) have been debated, with some preclinical studies suggesting associations with tumor promotion. However, clinical evidence regarding their impact on the risk of gynecological cancers remains limited and inconclusive, necessitating further investigation. Therefore we conducted a comprehensive search in PubMed, Embase, and Web of Science for studies examining the correlation between AD use and the risk of gynecological cancers.

Methods: The DerSimonian and Laird random-effects model was applied to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I-squared and Tau-squared statistics. Statistical analyses were performed using R software (version 4.4.1), with a significance threshold of p < 0.05.

Results: Our meta-analysis included 10 case-control studies, with a total of 965,834 participants, of whom 45,998 were AD users. The findings revealed a significant association between AD use and a reduced overall risk of gynecological cancers (OR = 0.9518; 95% CI: 0.9206 to 0.9841; P = 0.004; I² = 19%). Subgroup analyses demonstrated a decreased risk for ovarian cancer (OR = 0.9316; 95% CI: 0.9105 to 0.9531; P < 0.001; I² = 0%) and endometrial cancer (OR = 0.9264; 95% CI: 0.8683 to 0.9927; P = 0.030; I² = 19%). Additionally, selective serotonin reuptake inhibitors (SSRIs) were associated with a lower risk compared to non-AD users (OR = 0.9216; 95% CI: 0.8855 to 0.9591; P < 0.001; I² = 18.2%), as well as for ovarian cancer (OR = 0.9377; 95% CI: 0.8991 to 0.9780; P = 0.003; I² = 16%) and endometrial cancer (OR = 0.9078; 95% CI: 0.8251 to 0.9989; P = 0.047; I² = 35%).

Conclusions: Our meta-analysis indicates that AD use may serve as a protective factor against the development of gynecological cancers. However, potential biases and confounders should be considered, highlighting the need for balanced prescribing, taking into account the potential side effects of each AD and its suitability for individual patients.

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抗抑郁药使用与妇科癌症风险之间的关系：一项系统回顾和荟萃分析。

目的：抗抑郁药（ADs）的潜在致癌作用一直存在争议，一些临床前研究表明其与肿瘤促进有关。然而，关于它们对妇科癌症风险影响的临床证据仍然有限且不确定，需要进一步研究。因此，我们在PubMed， Embase和Web of Science中进行了全面的搜索，以检查AD使用与妇科癌症风险之间的相关性。方法：采用DerSimonian和Laird随机效应模型，以95%置信区间计算优势比（ORs）。异质性评估采用i平方和tau平方统计量。使用R软件（版本4.4.1）进行统计分析，显著性阈值为p。结果：我们的荟萃分析包括10项病例对照研究，共965,834名参与者，其中45,998名是AD用户。研究结果显示，使用AD与降低妇科癌症总体风险之间存在显著关联(OR = 0.9518；95% CI: 0.9206 ~ 0.9841；p = 0.004；i2 = 19%)。亚组分析显示卵巢癌风险降低(OR = 0.9316；95% CI: 0.9105 ~ 0.9531；P 2 = 0%)和子宫内膜癌(OR = 0.9264；95% CI: 0.8683 ~ 0.9927；p = 0.030；i2 = 19%)。此外，与非ad使用者相比，选择性血清素再摄取抑制剂（SSRIs）与较低的风险相关(OR = 0.9216；95% CI: 0.8855 ~ 0.9591；P 2 = 18.2%)，卵巢癌(OR = 0.9377；95% CI: 0.8991 ~ 0.9780；p = 0.003；I2 = 16%)和子宫内膜癌(OR = 0.9078；95% CI: 0.8251 ~ 0.9989；p = 0.047；i2 = 35%)。结论：我们的荟萃分析表明，AD的使用可能是预防妇科癌症发展的一个保护因素。然而，应该考虑到潜在的偏差和混杂因素，强调需要平衡处方，考虑到每种AD的潜在副作用及其对个体患者的适用性。

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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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.