[beta]-Blocker use and mortality in cancer patients: systematic review and meta-analysis of observational studies
A partir d'une revue systématique de la littérature (20 études de cohorte, 76 538 participants), cette méta-analyse évalue l'impact des bêta-bloquants sur la survie des patients atteints de cancer
A number of epidemiologic studies have attempted to link the use of [beta] blockers to mortality in cancer patients, but their findings have been inconclusive. A meta-analysis was carried out to derive a more precise estimation. Relevant studies were identified by searching PubMed and EMBASE to May 2015. We calculated the summary hazard ratios (HRs) and 95% confidence intervals (CIs) using random-effects models. Twenty cohort studies and four case-control studies involving 76 538 participants were included. The overall results showed that patients who used [beta] blockers after diagnosis had an HR of 0.89 (95% CI 0.81-0.98) for all-cause mortality compared with nonusers. Those who used [beta] blockers after diagnosis (vs. nonusers) had an HR of 0.89 (95% CI 0.79-0.99) for cancer-specific mortality. Prediagnostic use of [beta] blockers showed no beneficial effect on all-cause mortality or cancer-specific mortality. Stratifying by cancer type, only breast cancer patients who used [beta] blockers after diagnosis had a prolonged overall survival. A linear but nonsignificant trend was found between postdiagnostic [beta]-blocker use and mortality of cancer patients. In conclusion, the average effect of [beta]-blocker use after diagnosis but not before diagnosis is beneficial for the survival of cancer patients. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.