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Medicinski pregled
2006, vol. 59, br. 5-6, str. 213-218
jezik rada: srpski
vrsta rada: izvorni naučni članak
doi:10.2298/MPNS0606213S
Klinička ispitivanja statinai fibrata - prikaz metodom meta-analize
aAccelsiors CRO and Consultancy Services, Budapest
bKlinički centar Novi Sad
cUniverzitet u Novom Sadu, Medicinski fakultet

e-adresa: vid.stanulovic@accelsiors.com

Sažetak

Brojna velika klinička ispitivanja lekova za regulisanje nivoa lipoproteina krvi su pokazala smanjenje smrtnosti do 30-40%, ali i povećanje smrtnosti u nekim slučajevima. Pitanje je na osnovu kojeg ispitivanja zasnivati klinička prosuđivanja pri odabiru farmakoterapije hiperlipoproteinemija. Meta-analiza je metod za objedinjavanje rezultata više nezavisnih ispitivanja sličnih osobina za koje se smatra da se mogu kombinovati. Nakon sistematičnog pregleda literature i obrade metodom meta-analize procenjeno je delovanje statina i fibrata na smanjenje smrtnosti u poređenju sa placebom. Fibrati su pokazali gotovo potpuno odsustvo delovanja: Odnos verovatnoća smrtnosti 0,99 sa 95% rasponom poverenja 0,87-1,11. Statini su dali 13% sniženja smrtnosti sa odnosima 0,87, 0,80-0,95. Međutim, kriterijumi za uključivanje bolesnika u rana ispitivanja fibrata su uglavnom bili fokusirani na holesterol, dok je tek nedavno utvrđen značaj triglicerida kao nezavisnog faktora rizika od koronarne bolesti. Delovanje statina je potvrđeno, ali primetno niže nego u najintenzivnije promovisanim ispitivanjima. Značaj meta-analize je pokazan u sagledavanju sveukupnosti postojećih dokaza. Osnovano je koristiti je kao jedan od načina prikaza delovanja farmakološke intervencije.

Ključne reči

antilipemijski lekovi; hiperlipoprteinemija; klinička istraživanja; meta analiza ne mesh: Statini; fibrati

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