Thomas Datzmann1, Susanne Fuchs2, Daniel Andree3, Bernd Hohenstein4, Jochen Schmitt5, Christoph Schindler6. 1. National Center for Tumour Diseases, Dresden, Germany. Electronic address: thomas.datzmann@nct-dresden.de. 2. Department for Gynaecology and Obstetrics, Kreiskrankenhaus Freiberg, Freiberg, Germany. 3. Department of Medicine, Spital Limmattal, Zurich, Switzerland. 4. Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany; TU Dresden, Medizinische Fakultät Carl Gustav Carus, Medical Clinic 3, Division of Nephrology, Dresden, Germany. Electronic address: bernd.hohenstein@uniklinikum-dresden.de. 5. TU Dresden, Medizinische Fakultät Carl Gustav Carus, Center for Evidence-Based Healthcare, Dresden, Germany; National Center for Tumour Diseases, Dresden, Germany. Electronic address: jochen.schmitt@uniklinikum-dresden.de. 6. Hannover Medical School, Clinical Research Center Hannover & MHH Center for Pharmacology and Toxicology, Hannover Medical School, Hannover, Germany. Electronic address: schindler.christoph@mh-hannover.de.
Abstract
AIMS: The potential influence of angiotensin-receptor blockers (ARBs) on carcinogenesis is a much-debated topic. Both observational, as well as preclinical studies in rodent carcinogenic assays, suggest a major role of the Renin-Angiotensin-Aldosterone-System (RAAS) in cancer development. Therefore, a systematic review and meta-analysis with available study data on ARBs and carcinogenicity in general as primary outcome were conducted. Secondary outcomes were defined as tumour-specific mortality rates and the frequency of new cases of specific tumour types with particular emphasis on lung, breast, and prostate cancer. METHODS: A systematic literature research was performed in MEDLINE, EMBASE, Cochrane Library, and TOXLINE. We used a combination of MeSH terms, keywords and substance names of ARBs and searched between 1950 and 2016. At least 100 participants in each study arm and a minimum follow-up for one year were necessary for study inclusion. Odds ratios (OR) were calculated by a random-effects model. RESULTS: A total of 8818 potentially eligible publications were identified of whom seven randomised controlled trials, four case-control studies and one cohort study met our inclusion criteria. As a key result, we found no effect on carcinogenesis in randomised controlled trials for ARB usage. (OR 1.02, 95% CI 0.87-1.19; p = .803). Conflicting results with observational studies could be explained by poor reporting- and study qualities. CONCLUSIONS: The results of our meta-analysis focusing only on high evidence levels and study designs (RCTs) did not reveal any relationship between pharmacotherapy with an ARB and an increased risk for cancer in general.
AIMS: The potential influence of angiotensin-receptor blockers (ARBs) on carcinogenesis is a much-debated topic. Both observational, as well as preclinical studies in rodent carcinogenic assays, suggest a major role of the Renin-Angiotensin-Aldosterone-System (RAAS) in cancer development. Therefore, a systematic review and meta-analysis with available study data on ARBs and carcinogenicity in general as primary outcome were conducted. Secondary outcomes were defined as tumour-specific mortality rates and the frequency of new cases of specific tumour types with particular emphasis on lung, breast, and prostate cancer. METHODS: A systematic literature research was performed in MEDLINE, EMBASE, Cochrane Library, and TOXLINE. We used a combination of MeSH terms, keywords and substance names of ARBs and searched between 1950 and 2016. At least 100 participants in each study arm and a minimum follow-up for one year were necessary for study inclusion. Odds ratios (OR) were calculated by a random-effects model. RESULTS: A total of 8818 potentially eligible publications were identified of whom seven randomised controlled trials, four case-control studies and one cohort study met our inclusion criteria. As a key result, we found no effect on carcinogenesis in randomised controlled trials for ARB usage. (OR 1.02, 95% CI 0.87-1.19; p = .803). Conflicting results with observational studies could be explained by poor reporting- and study qualities. CONCLUSIONS: The results of our meta-analysis focusing only on high evidence levels and study designs (RCTs) did not reveal any relationship between pharmacotherapy with an ARB and an increased risk for cancer in general.
Authors: Yuxiu Xie; Men Wang; Peng Xu; Yujiao Deng; Yi Zheng; Si Yang; Ying Wu; Zhen Zhai; Dai Zhang; Na Li; Nan Wang; Jing Cheng; Zhijun Dai Journal: Front Pharmacol Date: 2021-05-13 Impact factor: 5.810
Authors: Danial Mehranfard; Gabriela Perez; Andres Rodriguez; Julia M Ladna; Christopher T Neagra; Benjamin Goldstein; Timothy Carroll; Alice Tran; Malav Trivedi; Robert C Speth Journal: J Renin Angiotensin Aldosterone Syst Date: 2021-07-05 Impact factor: 1.636