Use of antidepressants and the risk of breast cancer: a meta-analysis

The goal of this study was to perform a meta-analysis to examine the association between the use of antidepressants (AD) and the risk of breast cancer. We searched the EMBASE and MEDLINE databases from inception through February 25, 2012, using search terms related to ADs and breast cancer. Two evaluators independently reviewed and selected articles and extracted data based on predetermined selection criteria. Pooled effect estimates were obtained by using random- and fixed effects meta-analyses. Of the 3,209 titles identified, 18 articles met the inclusion criteria. The overall risk of breast cancer did not increase among AD users [adjusted odds ratio (aOR) 1.02; 95 % CI 0.96-1.08]. Those who took tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) were not at increased risks of breast cancer. In subgroup meta-analyses, null associations were consistent across the type of AD, funding sources, the number of adjusted variables, medication dose, the ascertainment of exposure, and methodological quality. In subgroup analyses based on exposure duration, a marginal association was observed for the use of SSRIs < 1-2 years (aOR 1.10; 95 % CI 1.02-1.19). However, this effect was attenuated over time and those using SSRIs for more than 1-2 years had no elevated breast cancer risk. These results support the lack of a clinically meaningful association between AD use and the development of breast cancer and provide considerable reassurance. Given that the data collected to date do not support changing the current prescribing patterns for ADs, the important benefits of AD therapy must be considered.N

Use of antidepressants and the risk of breast cancer: a meta-analysis

The goal of this study was to perform a meta-analysis to examine the association between the use of antidepressants (AD) and the risk of breast cancer. We searched the EMBASE and MEDLINE databases from inception through February 25, 2012, using search terms related to ADs and breast cancer. Two evaluators independently reviewed and selected articles and extracted data based on predetermined selection criteria. Pooled effect estimates were obtained by using random- and fixed effects meta-analyses. Of the 3,209 titles identified, 18 articles met the inclusion criteria. The overall risk of breast cancer did not increase among AD users [adjusted odds ratio (aOR) 1.02; 95 % CI 0.96-1.08]. Those who took tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) were not at increased risks of breast cancer. In subgroup meta-analyses, null associations were consistent across the type of AD, funding sources, the number of adjusted variables, medication dose, the ascertainment of exposure, and methodological quality. In subgroup analyses based on exposure duration, a marginal association was observed for the use of SSRIs < 1-2 years (aOR 1.10; 95 % CI 1.02-1.19). However, this effect was attenuated over time and those using SSRIs for more than 1-2 years had no elevated breast cancer risk. These results support the lack of a clinically meaningful association between AD use and the development of breast cancer and provide considerable reassurance. Given that the data collected to date do not support changing the current prescribing patterns for ADs, the important benefits of AD therapy must be considered.OAIID:oai:osos.snu.ac.kr:snu2012-01/102/0000052039/12SEQ:12PERF_CD:SNU2012-01EVAL_ITEM_CD:102USER_ID:0000052039ADJUST_YN:YEMP_ID:A077862DEPT_CD:801CITE_RATE:4.431FILENAME:62_Use of antidepressants and the risk of breast cancer_ a meta-analysis.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM:

Use of selective serotonin reuptake inhibitors and risk of stroke: a systematic review and meta-analysis

Since several studies have inconsistently reported the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of stroke, we performed a meta-analysis on this issue. We identified studies by searching three electronic databases (MEDLINE, EMBASE, and the Cochrane Library) from their inception to August, 2013. Pooled effect estimates were obtained by using random-effects meta-analysis. Thirteen relevant studies (three case-control, six nested case-control, and four cohort studies) were finally included in our study. In our meta-analyses, the use of SSRIs was associated with an increased risk of all types of stroke [adjusted odds ratio (aOR), 1.40; 95 % confidence interval (CI), 1.09-1.80], ischemic stroke (aOR 1.48; 95 % CI 1.08-2.02), and hemorrhagic stroke (aOR 1.32; 95 % CI 1.02-1.71). Between the two subtypes of hemorrhagic stroke, that is, intracerebral and subarachnoid, the increased risk of intracerebral hemorrhage was associated with the use of SSRIs (aOR 1.30; 95 % CI 1.02-1.67). When the analysis was restricted to the studies in which potential confounding by depression was considered, the risks were still higher in SSRI users than in non-users and the heterogeneities among studies were significantly decreased. Since there was heterogeneity among studies and a possible confounding effect from depression could not be fully excluded, further well-designed studies are needed to confirm this association.OAIID:oai:osos.snu.ac.kr:snu2014-01/102/0000052039/3SEQ:3PERF_CD:SNU2014-01EVAL_ITEM_CD:102USER_ID:0000052039ADJUST_YN:YEMP_ID:A079543DEPT_CD:806CITE_RATE:3.841FILENAME:use of selective serotonin reuptake inhibitors and risk of stroke, a systematic review and meta-analysis..pdfDEPT_NM:의과학과SCOPUS_YN:YCONFIRM:

Use of selective serotonin reuptake inhibitors and risk of fracture: A systematic review and meta-analysis

Previous studies have reported inconsistent findings regarding the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of fracture. We identified relevant studies by searching three electronic databases (MEDLINE, EMBASE, and the Cochrane Library) from their inception to October 20, 2010. Two evaluators independently extracted data. Because of heterogeneity, we used random-effects meta-analysis to obtain pooled estimates of effect. We identified 12 studies: seven case-control studies and five cohort studies. A meta-analysis of these 12 observational studies showed that the overall risk of fracture was higher among people using SSRIs (adjusted odds ratio [OR]?=?1.69, 95% confidence interval [CI] 1.511.90, I2?=?89.9%). Subgroup analysis by adjusted number of key risk factors for osteoporotic fracture showed a greater increased fracture risk in those adjusted for fewer than four variables (adjusted OR?=?1.83, 95% CI 1.572.13, I2?=?88.0%) than those adjusted for four or more variables (adjusted OR?=?1.38, 95% CI 1.271.49, I2?=?46.1%). The pooled ORs anatomical site of fracture in the hip/femur, spine, and wrist/forearm were 2.06 (95% CI 1.842.30, I2?=?62.3%), 1.34 (95% CI 1.131.59, I2?=?48.5%), and 1.51 (95% CI 1.261.82, I2?=?76.6%), respectively. Subgroup analysis by exposure duration revealed that the strength of the association decreased with a longer window of SSRI administration before the index date. The risk of fracture was greater within 6 weeks before the index date (adjusted OR?=?3.83, 95% CI 1.967.49, I2?=?41.5%) than 6 weeks or more (adjusted OR?=?1.60, 95% CI 0.932.76, I2?=?63.1%). Fracture risk associated with SSRI use may have a significant clinical impact. Clinicians should carefully consider bone mineral density screening before prescribing SSRIs and proper management for high-risk populations. (c) 2012 American Society for Bone and Mineral Research.N

Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies

Background: Previous case-control studies have reported inconsistent findings regarding the association between protonpump inhibitor (PPI) use and colorectal cancer (CRC) risk. We investigated these associations using meta-analysis.Methods: We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library in April 2011. Two evaluatorsindependently reviewed and selected articles, based on pre-determined selection criteria.Results: Out of 737 articles meeting our initial criteria, 5 case-control studies, which involved 120,091 participants (9,514cases and 110,577 controls), were included in the final analyses. The overall use of PPI (used vs. never or rarely used) wasnot significantly associated with the risk of CRC in a fixed-effects model meta-analysis of all 5 case-control studies (oddsratio [OR], 1.08; 95% confidence interval [CI], 0.96 to 1.20; I2 = 3.5%). Also, in sensitivity meta-analysis by cumulativeduration of PPI use, there was no association between PPI use of 1 year or longer and the risk of colorectal cancer in afixed-effects meta-analysis (OR, 1.09; 95% CI, 0.98 to 1.22; I2 = 0%).Conclusion: Although hypergastrinemia could be an important factor in the pathogenesis of some colorectal cancers,our study suggests that this does not lead to significant clinical risk for most PPI users. Further prospective studies orrandomized controlled trials related to PPI use and colorectal cancer risk are needed to investigate this association.OAIID:oai:osos.snu.ac.kr:snu2012-01/102/0000052039/16SEQ:16PERF_CD:SNU2012-01EVAL_ITEM_CD:102USER_ID:0000052039ADJUST_YN:YEMP_ID:A077862DEPT_CD:801CITE_RATE:0FILENAME:61_Use of Proton Pump Inhibitor and Risk of Colorectal.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:NCONFIRM:

Pre-existing diabetes mellitus increases the risk of gastric cancer: A meta-analysis

AIM: To systematically assess the association between diabetes and incidence of gastric cancer. METHODS: We searched MedLine (PubMed), EMBASE, and the Cochrane Library without any limitations with respect to publication date or language, we also searched the references of qualifying articles. Case-control studies and cohort studies comparing the risk of gastric cancer between diabetic patients and control subjects were included. We excluded studies reporting only standardized incidence ratios without control groups and those that investigated only mortality but not incidence. Seventeen studies met our criteria, and the qualities of these studies were assessed using the Newcastle-Ottawa Quality Assessment Scale. We performed a meta-analysis of pre-existing diabetes and gastric cancer incidence using the DerSimonian-Laird method for random-effects. For subgroup analyses, we separated the studies by study type, region, sex and method to determine confounding factors and reliability. We also conducted subgroup analyses to examine the effects of smoking, Helicobacter pylori (H. pylori) infection, and cancer site. Publication bias was evaluated using Begg's test.RESULTS: A random-effects model meta-analysis showed an increased gastric cancer risk in diabetic patients [relative risk (RR# = 1.19; 95%CI: 1.08-1.31]. Subgroup analyses indicated that this result persisted in cohort studies #RR = 1.20; 95%CI: 1.08-1.34#, in studies on populations of both Western #RR = 1.18; 95%CI: 1.03-1.36# and Eastern countries #RR = 1.19; 95%CI: 1.02-1.38#, in a female subgroup #RR = 1.24; 95%CI: 1.01-1.52#, and in highly qualified studies #RR = 1.17; 95%CI: 1.05-1.31#. Moreover, these results persisted when the analysis was confined to studies adjusted for well-known gastric cancer risk factors such as smoking #RR = 1.17; 95%CI: 1.01-1.34# and H. pylori infection #RR = 2.35; 95%CI: 1.24-4.46#.CONCLUSION: Pre-existing diabetes mellitus may increase the risk of gastric cancer by approximately 19%. This effect seems to be unrelated to geographical region. #C) 2013 Baishideng. All rights reserved.Supported by Grant from the Seoul National University Hospital Research Fund, No. 04-2011-0540OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000052039/1SEQ:1PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000052039ADJUST_YN:YEMP_ID:A077862DEPT_CD:806CITE_RATE:2.471FILENAME:Pre-existing diabetes mellitus increases the risk of gastric cancer, A meta-analysis.pdfDEPT_NM:의과학과EMAIL:[email protected]_YN:YCONFIRM:

Use of Acid-Suppressive Drugs and Risk of Fracture: A Meta-analysis of Observational Studies

PURPOSE Previous studies have reported inconsistent findings regarding the association between the use of acid-suppressive drugs such as proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RAs) and fracture risk. We investigated this association using meta-analysis

Meta-analysis: selective serotonin reuptake inhibitors and colon cancer

Objective To perform meta-analyses using observational studies to assess the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of colorectal cancer.Methods A systematic search of relevant studies published through February 2012 was carried out using the Medline (PubMed), Embase, and Cochrane Library databases. We reviewed the observational studies that were associated with our subject and carried out a meta-analysis.Results Out of 324 screened articles, six observational studies were included in the final analyses. According to this meta-analysis, the use of SSRIs was not associated with an increased risk of colorectal cancer in pooled analyses (adjusted odds ratio 0.89, 95% confidence interval 0.79-1.01). This finding was consistently observed in subgroup analyses of study area, location of colorectal cancer, duration of SSRI use, study quality, adjustment for NSAID use, and the prevalence of overweight.Conclusion Our research shows that the use of SSRIs does not increase the risk of colorectal cancer. Further studies are needed to confirm the association between SSRIs and colorectal cancer. Eur J Gastroenterol Hepatol 24:1153-1157 (C) 2012 Wolters Kluwer Health | Lippincott Williams Wilkins.OAIID:oai:osos.snu.ac.kr:snu2012-01/102/0000052039/6SEQ:6PERF_CD:SNU2012-01EVAL_ITEM_CD:102USER_ID:0000052039ADJUST_YN:YEMP_ID:A077862DEPT_CD:801CITE_RATE:1.757FILENAME:53_Meta-analysis_ selective serotonin reuptake inhibitors and colon cancer.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM: