西地那非(伟哥)的使用与黑素瘤风险增加有关_伟哥

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所属分类:医学快讯
摘要

摘自2014年6月刊JAMA Intern Med: ———————————- Sildenafil Use and Increased Risk of Incident Melanoma in US MenA Prospective Cohort Study Importance The RAS/RAF/mitogen-activated protein kinase and extracellular signal

食药总局:警惕部分产品非法添加“西地那非”

 一、背景信息       近日,有媒体报道,不法分子受利益驱动将“伟哥”主要成分西地那非掺入粉中,制成大量号称具有壮阳作用的非法产品。西地那非是什么?西地那非有什么危害?本期为您解读。       二、专家观点       (一)西地那非为处方药,须在医生指导

摘自2014年6月刊JAMA Intern Med:

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Sildenafil Use and Increased Risk of Incident Melanoma in US MenA Prospective Cohort Study

Importance The RAS/RAF/mitogen-activated protein kinase and extracellular signal–regulated kinase (ERK) kinase/ERK cascade plays a crucial role in melanoma cell proliferation and survival. Sildenafil citrate (Viagra) is a phosphodiesterase (PDE) 5A inhibitor commonly used for erectile dysfunction. Recent studies have shown that BRAF activation down-regulates PDE5A levels, and low PDE5A expression by BRAF activation or sildenafil use increases the invasiveness of melanoma cells, which raises the possible adverse effect of sildenafil use on melanoma risk.

背景:RAS/RAF/促分裂原活化蛋白激酶和细胞外信号调节激酶(ERK)ERK激酶/ERK级联系统在黑素瘤细胞的增殖和存活中起重要作用。枸橼酸西地那非(万艾可,“伟哥”)是一种磷酸二酯酶(PDE) 5A抑制剂,常用于治疗勃起功能障碍。最近有研究报道,BRAF活化可导致PDE5A水平下调,而BRAF活化或西地那非可引起PDE5A的低表达,导致黑素瘤细胞的侵袭性增强。因此,西地那非可能与黑素瘤諷險增加有关。

Objective To evaluate the association between sildenafil use and risk of incident melanoma among men in the United States.

目的:以美国男性为对象,评估西地那非与黑素瘤发病之间的联系。

Design, Setting, and Participants Our study is a prospective cohort study. In 2000, participants in the Health Professionals’ Follow-up Study were questioned regarding sildenafil use for erectile dysfunction. Participants who reported cancers at baseline were excluded. A total of 25 848 men remained in the analysis.

研究设计:(简略)前瞻性队列研究。

Main Outcomes and Measures The incidence of skin cancers, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), was obtained in the self-reported questionnaires biennially. The diagnosis of melanoma and SCC was pathologically confirmed.

主要结局和测定:皮肤癌症的发病率,包括黑素瘤、鳞状细胞癌(SCC)和基底细胞癌(BCC)。通过问卷的形式测定。黑素瘤和SCC的确诊均经过病理学确定。

Results We identified 142 melanoma, 580 SCC, and 3030 BCC cases during follow-up (2000-2010). Recent sildenafil use at baseline was significantly associated with an increased risk of subsequent melanoma with a multivariate-adjusted hazard ratio (HR) of 1.84 (95% CI, 1.04-3.22). In contrast, we did not observe an increase in risk of SCC (HR, 0.84; 95% CI, 0.59-1.20) or BCC (1.08; 0.93-1.25) associated with sildenafil use. Moreover, erectile function itself was not associated with an altered risk of melanoma. Ever use of sildenafil was also associated with a higher risk of melanoma (HR, 1.92; 95% CI, 1.14-3.22). A secondary analysis excluding those reporting major chronic diseases at baseline did not appreciably change the findings; the HR of melanoma was 2.24 (95% CI, 1.05-4.78) for sildenafil use at baseline and 2.77 (1.32-5.85) for ever use.

结果:随访期间(2000年至2010年),我们共记录142例黑素瘤,580例SCC和3030例BCC。基线的西地那非近期服药史与随后的黑素瘤諷險增加之间存在显著联系,多因素校正后的諷險比为1.84。此外,我们并未发现SCC或BCC与西地那非存在联系。勃起功能障碍与黑素瘤之间也不存在联系。西地那非的服药史与更高的黑素瘤諷險之间也有联系(HR为1.92)。在排除其它主要慢性疾病的次要分析中,我们仍观察到类似的结论;如果患者有基线西地那非服药史,则黑素瘤的HR为2.23。如果患者曾经服用西地那非,则黑素瘤HR为2.77。

Conclusions and Relevance Sildenafil use may be associated with an increased risk of developing melanoma. Although this study is insufficient to alter clinical recommendations, we support a need for continued investigation of this association.

结论:西地那非的使用可能与黑素瘤諷險增加之间存在联系。尽管本研究并不足以改变目前的临床指南,但我们支持进行更多的研究以明确二者的联系。

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广州-西地那非 基本信息 【广州】西地那非-4200(9.28/29有烟检) 人脸识别广州三甲医院 全国联网 有烟检 抽血失败补贴50路费 营养补助:2天4000元 药物名称:西地那非 入住人数:42人 体检时间 2019年9月28号/29号 入住时间: 第一周期: 2019年10月11号下午

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