抗炎治疗与心血管疾病或高危心血管患者肾脏预后之间的关系：随机对照试验的荟萃分析

IF 4.6 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2025-03-19 DOI:10.1007/s10787-025-01711-3

Wenfeng Yang, Zonglin Li, Chu Lin, Xiaoling Cai, Fang Lv, Wenjia Yang, Linong Ji

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引用次数: 0

摘要

背景：评估有心血管风险或诊断为心血管疾病（CVD）的受试者抗炎治疗与肾脏事件风险之间的关系。方法：在PubMed、Embase、clinicaltrial.gov和Cochrane Central Register of Controlled Trials中进行文献检索。1995年1月至2024年7月发表的随机对照试验，比较了抗炎治疗和安慰剂对有心血管风险或诊断为心血管疾病的参与者的影响，并报告了肾脏结果。结果用风险比（RR）和95%置信区间（CI）表示。结果：与安慰剂相比，针对炎症的治疗与复合肾脏结局（肾功能恶化、肾脏疾病死亡和终末期肾脏疾病）的风险没有显著关联（RR = 0.89, 95% CI 0.40至1.99,I2 = 0%）。肾功能恶化的风险(RR = 0.81, 95%可信区间0.21到3.07,I2 = NA),终末期肾病(RR = 0.94, 95%可信区间0.31到2.85,I2 = 0%),死亡由于肾脏疾病(RR = 3.00, 95%可信区间0.12到73.56,I2 = NA),慢性肾脏疾病(RR = 1.77, 95%可信区间0.74到4.23,I2 = 0%),慢性肾功能衰竭(RR = 1.70, 95%可信区间0.56到5.15,I2 = 61%)和急性肾损伤(RR = 1.16, 95%可信区间0.95到1.42,I2 = 0%)，抗炎治疗组与安慰剂组无显著差异。结论：目前的证据表明抗炎治疗与心血管风险或已确诊心血管疾病患者肾脏不良事件风险之间没有关联。抗炎治疗对肾脏的影响有待进一步研究。

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The association between anti-inflammatory therapies and renal outcomes in patients with established cardiovascular disease or high cardiovascular risks: a meta-analysis of randomised controlled trials.

Background: To assess the relationship between anti-inflammatory therapy and renal events risk in participants with cardiovascular risks or diagnosed cardiovascular disease (CVD).

Methods: Literature searches were carried out in PubMed, Embase, clinicaltrial.gov and the Cochrane Central Register of Controlled Trials. Randomised controlled trials that were published from January 1995 to July 2024, compared anti-inflammatory therapy and placebo in participants at cardiovascular risks or with diagnosed CVD and with reports of renal outcomes were included. The results were shown as risk ratio (RR) and 95% confidence interval (CI).

Results: In comparison to placebo, therapies targeting inflammation did not exhibit a significant association with the risk of composite renal outcomes (worsening of renal function, death due to kidney disease and end-stage renal disease) (RR = 0.89, 95% CI 0.40 to 1.99, I² = 0%). The risk of worsening of renal function (RR = 0.81, 95% CI 0.21 to 3.07, I² = NA), end-stage renal disease (RR = 0.94, 95% CI 0.31 to 2.85, I² = 0%), death due to kidney disease (RR = 3.00, 95% CI 0.12 to 73.56, I² = NA), chronic kidney disease (RR = 1.77, 95% CI 0.74 to 4.23, I² = 0%), chronic renal failure (RR = 1.70, 95% CI 0.56 to 5.15, I² = 61%) and acute kidney injury (RR = 1.16, 95% CI 0.95 to 1.42, I² = 0%) showed no significant difference between patients receiving anti-inflammatory therapy and placebo.

Conclusion: Current evidence did not indicate associations between anti-inflammatory therapies and adverse renal events risks in patients with cardiovascular risks or established CVD. Future researches are needed to explore the renal effects of anti-inflammatory therapy.

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]