Statins and uterine fibroids: Potential for a novel therapeutic approach
Notice bibliographique
Résumé
BACKGROUND: Uterine fibroids are the most common benign gynecological tumors, affecting up to 70% of women. Only 25% of women with uterine fibroids are symptomatic. Despite the significant clinical burden, no satisfactory long-term medical therapy is currently available. Definitive management often warrants surgery, which might result in significant morbidity and economic burden. Therefore, there is a growing need for novel and effective medical therapy. Statins have shown broad-reaching pleiotropic effects on uterine fibroids, potentially inhibiting growth, reducing the incidence, and alleviating the symptoms. OBJECTIVES: The current study aims to explore the pathophysiological mechanisms and clinical effects of statins on uterine fibroids. SEARCH STRATEGY: We retrieved relevant studies from PubMed, Cochrane Library, Embase, and ScienceDirect, published up to January 3, 2025. The study selection process was conducted using the semi-automated tool Rayyan. SELECTION CRITERIA: Full-text articles of randomized controlled trials (RCTs), case-control studies, cross-sectional studies, cohort studies, case series, and experimental studies in the English language that describe the pathophysiological mechanisms and clinical effects of statins on uterine fibroids were included. Review articles or book chapters were excluded. DATA COLLECTION AND ANALYSIS: Key study characteristics were organized into predefined tables concerning outcome measures: pathophysiological mechanisms and clinical effects. Data synthesis involved a thematic analysis. A meta-analysis was not performed due to study heterogeneity. Study quality assessment was conducted using the Newcastle-Ottawa Scale (NOS), the Cochrane risk-of-bias (RoB1) tool, and the Quality Assessment Tool for In Vitro Studies (QUIN Tool). MAIN RESULTS: We included 13 studies screening 574 studies from four databases, where eight were laboratory-based experimental studies, four were clinical studies, and one provided data on both. Quality assessment graded the studies as moderate to high quality. Statins exhibited diverse pharmacodynamic effects on leiomyoma cells, including a reduction in estrogen receptor-α (ER-α) levels and activity, alterations in intracellular signaling pathways that regulate cell proliferation, a decrease in extracellular matrix (ECM) production, induction of apoptosis, and improvements in altered cellular mechanotransduction, as well as changes in stemness markers. Clinical studies have demonstrated that statins have a significant impact on reducing fibroid volume and alleviating symptoms associated with fibroids. CONCLUSION: Statins have demonstrated anti-proliferative and pro-apoptotic effects on uterine fibroids, resulting in symptomatic improvement and reduction in fibroid volume in clinical studies. However, given the paucity of evidence, it is challenging to conclude on the comparative efficacy, the most appropriate type of statin, the optimal dosing regimen, and the treatment duration, thereby creating a potential research gap. Therefore, we recommend well-planned prospective studies to establish the role of statins in the management of uterine fibroids.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,003 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,004 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».