或降低16%的患癌风险!华法林又有新用途
2017/11/09
近年来,包括阿司匹林、二甲双胍、雷帕霉素在内的“神药”一直是研究的热点。除了最初的药物功效之外,这些药物都被证实在抗肿瘤、抗衰老等多个领域有着巨大的潜能。现在,又一款传统药物被挖掘,它就是华法林!最新一项超百万人的研究揭示,它可以降低癌症16%的发生概率!


11月6日,《JAMA Internal Medicine》期刊发表一篇文章题为“Association of Warfarin Use With Lower Overall Cancer Incidence Among Patients Older Than 50 Years”的文章,来自于挪威Bergen 大学的James B. Lorens及其团队发现,华法林(Warfarin)可以降低癌症的发生概率,特别是对于50岁以上的老年人而言。

抗血液凝结的黄金药物

华法林(华法林钠)是一种抗凝血剂(血液稀释剂),通过阻止维生素K产生而防止血凝块的形成。它适用于预防和治疗心梗、脑梗、中风、深度静脉血栓等与血凝块有关的疾病,同时心律失常、有人造心脏瓣膜的患者也可以服用该药物预防血凝块风险。

华法林药效持久、价格低廉,是一款平民救命药。除了抗血凝,已有研究显示它或许可以阻止癌症的发展——通过抑制一种维生素K依赖蛋白Gas6的表达抑制AXL受体酪氨酸激酶的活性,从而阻止癌细胞的扩散。

降低16%的患癌风险

James B. Lorens团队分析了挪威国家注册中心、挪威处方药数据库以及癌症登记中心的数据,共囊括自1924年1月至1954年12月期间出生在挪威的1,256,725个人(其中超一半是女性)的相关信息,包括华法林服用情况(从2004年1月到2012年12月)、癌症发病率(从2006年1月至2012年12月)。

结果显示,92,942人服用过华法林。而且,相比于未曾服用过华法林的人,使用华法林会降低16%的患癌风险。具体而言,华法林可以降低31%的前列腺癌风险,20%的肺癌风险,10%的乳腺癌风险。

华法林提供“抗癌保护”?

研究团队认为,这些数据表明,华法林或许有助于预防癌症。但是这只是一项观察性研究,所以无法证明因果。而且他们没有考虑可能影响癌症发生风险的其他因素,例如饮食、体重、吸烟状况。所以,还需要更多的研究明确华法林对癌症发展的潜在机制。

参考资料:

Warfarin may prevent cancer

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  • Association of Warfarin Use With Lower Overall Cancer Incidence Among Patients Older Than 50 Years

    Importance In cancer models, warfarin inhibits AXL receptor tyrosine kinase–dependent tumorigenesis and enhances antitumor immune responses at doses not reaching anticoagulation levels. This study investigates the association between warfarin use and cancer incidence in a large, unselected population-based cohort. Objective To examine the association between warfarin use and cancer incidence. Design, Setting, and Participants This population-based cohort study with subgroup analysis used the Norwegian National Registry coupled with the Norwegian Prescription Database and the Cancer Registry of Norway. The cohort comprised all persons (N = 1 256 725) born between January 1, 1924, and December 31, 1954, who were residing in Norway from January 1, 2006, through December 31, 2012. The cohort was divided into 2 groups—warfarin users and nonusers; persons taking warfarin for atrial fibrillation or atrial flutter were the subgroup. Data were collected from January 1, 2004, to December 31, 2012. Data analysis was conducted from October 15, 2016, to January 31, 2017. Exposures Warfarin use was defined as taking at least 6 months of a prescription and at least 2 years from first prescription to any cancer diagnosis. If warfarin treatment started after January 1, 2006, each person contributed person-time in the nonuser group until the warfarin user criteria were fulfilled. Main Outcomes and Measures Cancer diagnosis of any type during the 7-year observation period (January 1, 2006, through December 31, 2012). Results Of the 1 256 725 persons in the cohort, 607 350 (48.3%) were male, 649 375 (51.7%) were female, 132 687 (10.6%) had cancer, 92 942 (7.4%) were classified as warfarin users, and 1 163 783 (92.6%) were classified as nonusers. Warfarin users were older, with a mean (SD) age of 70.2 (8.2) years, and were predominantly men (57 370 [61.7%]) as compared with nonusers, who had a mean (SD) age of 63.9 (8.6) years and were mostly women (613 803 [52.7%]). Among warfarin users and compared with nonusers, there was a significantly lower age- and sex-adjusted incidence rate ratio (IRR) in all cancer sites (IRR, 0.84; 95% CI, 0.82-0.86) and in prevalent organ-specific sites (lung, 0.80 [95% CI, 0.75-0.86]; prostate, 0.69 [95% CI, 0.65-0.72]; and breast, 0.90 [95% CI, 0.82-1.00]). There was no observed significant effect in colon cancer (IRR, 0.99; 95% CI, 0.93-1.06). In a subgroup analysis of patients with atrial fibrillation or atrial flutter, the IRR was lower in all cancer sites (IRR, 0.62; 95% CI, 0.59-0.65) and in prevalent sites (lung, 0.39 [95% CI, 0.33-0.46]; prostate, 0.60 [95% CI, 0.55-0.66]; breast, 0.72 [95% CI, 0.59-0.87]; and colon, 0.71 [95% CI, 0.63-0.81]). Conclusions and Relevance Warfarin use may have broad anticancer potential in a large, population-based cohort of persons older than 50 years. This finding could have important implications for the selection of medications for patients needing anticoagulation.

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