Aliment Pharmacol Ther:雷尼替丁是否会增加消化道癌症的风险?

2021-07-25 Nebula MedSci原创

与使用奥美拉唑或法莫替丁相比,使用雷尼替丁并不增加发生胃肠道恶性肿瘤的几率

雷尼替丁,又名呋喃硝胺,为强效组胺H2受体拮抗剂。作用比西咪替丁强5~8倍,且作用时间更持久。能有效地抑制组胺、五肽胃泌素和氨甲酰胆碱刺激后引起的胃酸分泌,降低胃酸和胃酶活性,主要用于胃酸过多、烧心的治疗。

在2019年,美国食品和药物管理局(FDA)检测到雷尼替丁中的人类致癌物N-亚硝基二甲胺(NDMA)超标,导致该药物彻底退出美国市场(在国内仍在应用)。众所周知,NDMA还可导致动物模型发生胃肠道恶性肿瘤。

近期发表在“Aliment Pharmacol Ther”杂志上的一项研究,探索了雷尼替丁相比其他抗反流药物,是否会增加患者患消化道癌症的风险。

该研究使用IBM Explorys数据库,将服用雷尼替丁的患者与服用法莫替丁或奥美拉唑的患者进行了比较。每间隔1年评估一次食管、胃、肝脏、胰腺和结肠/直肠的新恶性肿瘤的发病率,最长持续10年。

法莫替丁、奥美拉唑、雷尼替丁使用者的消化道癌症发生率

与使用法莫替丁的患者相比,使用雷尼替丁的患者患食管癌、胃癌、肝癌、胰腺癌结直肠癌的优势比(OR)分别为0.51(95% CI 0.43-0.60)、0.43(95% CI 0.36-0.51)、0.39(95% CI 0.36-0.41)、0.54(95% CI 0.49-0.62)和0.46(95% CI 0.43-0.49)(P<0.001)。与使用奥美拉唑的患者相比,使用雷尼替丁的患者患食管癌、胃癌、肝癌、胰腺癌和结直肠癌的OR分别是0.62(95% CI 0.52-0.72)、0.58(95% CI 0.49-0.68)、0.81 (95% CI 0.76-0.86)、0.68(95% CI 0.60-0.76)和0.66(95% CI 0.62-0.70)。

综上所述,与使用奥美拉唑或法莫替丁相比,使用雷尼替丁并不增加发生胃肠道恶性肿瘤的几率

原始出处:

Kim Yeseong D,Wang Jiasheng,Shibli Fahmi et al. No association between chronic use of ranitidine, compared with omeprazole or famotidine, and gastrointestinal malignancies.[J] .Aliment Pharmacol Ther, 2021, https://doi.org/10.1111/apt.16464

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    2021-12-11 jj000001
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    2021-09-13 yb6560
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1788436, encodeId=c7731e8843661, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Tue Jan 04 02:32:15 CST 2022, time=2022-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787730, encodeId=b6fb1e8773072, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat Dec 11 08:32:15 CST 2021, time=2021-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908646, encodeId=620f190864644, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Wed Jul 06 18:32:15 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996416, encodeId=e64e199641605, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Mon Sep 13 19:32:15 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464683, encodeId=81861464683a0, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Tue Jul 27 10:32:15 CST 2021, time=2021-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002546, encodeId=5c251002546c6, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Sun Jul 25 19:50:42 CST 2021, time=2021-07-25, status=1, ipAttribution=)]
    2021-07-25 yangchou

    好文章,谢谢分享。

    0

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