Huilin Tang1,2,3, Shuangshuang Fu4, Suodi Zhai1, Yiqing Song2,3, Maryam M Asgari5, Jiali Han2,3,6. 1. Department of Pharmacy, Peking University Third Hospital, Beijing, China. 2. Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA. 3. Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA. 4. School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA. 5. Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA. 6. Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, USA.
Abstract
PURPOSE: Current epidemiologic evidence on the association between antihypertensive drugs and keratinocyte carcinoma (KC) risk is inconsistent. We sought to quantify this association by meta-analysis of observational studies. METHODS: We systematically reviewed observational studies published through August 2016 and reported the KC risk (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) associated with antihypertensive drugs, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-adrenergic blocking agents (β-blockers), and calcium channel blockers (CCBs). Random-effects meta-analysis was used to estimate the odds ratio (OR) with 95% confidence interval (CI). RESULTS: Ten eligible studies were included. Compared with nonuse, diuretic use was significantly associated with increased risk of both BCC (OR, 1.10; 95% CI, 1.01-1.20) and SCC (OR, 1.40; 95% CI, 1.19-1.66). Use of β-blockers or CCBs was associated with increased risk of BCC (but not SCC); the OR with β-blockers was 1.09 (95% CI, 1.04-1.15) and with CCBs was 1.15 (95% CI, 1.09-1.21). Use of ACE inhibitors or ARBs was associated with decreased risk of both BCC (OR, 0.53; 95% CI, 0.39-0.71) and SCC (OR, 0.58; 95% CI, 0.42-0.80) in high-risk individuals. CONCLUSIONS: Current evidence indicates that use of diuretics might be associated with increased risk of KC, while ACE inhibitors or ARBs might be associated with decreased risk in high-risk individuals. β-blockers or CCBs might be positively associated with BCC risk. Further postmarketing surveillance studies and investigations to clarify the possible underlying mechanisms are warranted.
PURPOSE: Current epidemiologic evidence on the association between antihypertensive drugs and keratinocyte carcinoma (KC) risk is inconsistent. We sought to quantify this association by meta-analysis of observational studies. METHODS: We systematically reviewed observational studies published through August 2016 and reported the KC risk (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) associated with antihypertensive drugs, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-adrenergic blocking agents (β-blockers), and calcium channel blockers (CCBs). Random-effects meta-analysis was used to estimate the odds ratio (OR) with 95% confidence interval (CI). RESULTS: Ten eligible studies were included. Compared with nonuse, diuretic use was significantly associated with increased risk of both BCC (OR, 1.10; 95% CI, 1.01-1.20) and SCC (OR, 1.40; 95% CI, 1.19-1.66). Use of β-blockers or CCBs was associated with increased risk of BCC (but not SCC); the OR with β-blockers was 1.09 (95% CI, 1.04-1.15) and with CCBs was 1.15 (95% CI, 1.09-1.21). Use of ACE inhibitors or ARBs was associated with decreased risk of both BCC (OR, 0.53; 95% CI, 0.39-0.71) and SCC (OR, 0.58; 95% CI, 0.42-0.80) in high-risk individuals. CONCLUSIONS: Current evidence indicates that use of diuretics might be associated with increased risk of KC, while ACE inhibitors or ARBs might be associated with decreased risk in high-risk individuals. β-blockers or CCBs might be positively associated with BCC risk. Further postmarketing surveillance studies and investigations to clarify the possible underlying mechanisms are warranted.
Authors: Emma Copland; Dexter Canoy; Milad Nazarzadeh; Zeinab Bidel; Rema Ramakrishnan; Mark Woodward; John Chalmers; Koon K Teo; Carl J Pepine; Barry R Davis; Sverre Kjeldsen; Johan Sundström; Kazem Rahimi Journal: Lancet Oncol Date: 2021-04 Impact factor: 41.316
Authors: Elisabeth A George; Navya Baranwal; Jae H Kang; Abrar A Qureshi; Aaron M Drucker; Eunyoung Cho Journal: Cancers (Basel) Date: 2021-05-12 Impact factor: 6.639