scholarly journals Abatacept initiation in rheumatoid arthritis and the risk of cancer: a population-based comparative cohort study

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 683-691 ◽  
Author(s):  
François Montastruc ◽  
Christel Renoux ◽  
Sophie Dell’Aniello ◽  
Teresa A Simon ◽  
Laurent Azoulay ◽  
...  
Keyword(s):  
Cohort Study ◽  
Skin Cancer ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Non Melanoma Skin Cancer ◽  
Increased Risk ◽  
Significant Difference ◽  
Specific Cancer ◽  
Risk Of Cancer ◽  
Melanoma Skin

Abstract Objective To assess whether abatacept as initial biological DMARD (bDMARD) in the treatment of RA, when compared with other bDMARDs, is associated with an increased risk of cancer overall and by specific cancer sites (breast, lung, lymphoma, melanoma and non-melanoma skin cancer). Methods We performed a population-based cohort study among patients newly treated with bDMARDs within the US-based Truven MarketScan population and Supplemental US Medicare from 2007 to 2014. Cox proportional hazards models were used to estimate hazard ratios and 95% CIs of any cancer (and specific cancers) associated with initiation of abatacept, compared with initiation of other bDMARDs, adjusted for age and deciles of the propensity score. Results The cohort included 4328 patients on abatacept and 59 860 on other bDMARDs, of whom 409 and 4197 were diagnosed with any cancer during follow-up (incidence rates 4.76 per 100 per year and 3.41 per 100 per year, respectively). Compared with other bDMARDs, the use of abatacept was associated with an increased incidence of cancer overall (hazard ratioadjusted 1.17; 95% CI 1.06, 1.30). Analyses by specific cancer sites showed a significantly increased incidence of non-melanoma skin cancer (hazard ratioadjusted 1.20; 95% CI 1.03, 1.39), but no significant difference for other specific cancer sites. Conclusion The use of abatacept as first bDMARD in the treatment of RA was associated with a slight increased risk of cancer overall and particularly non-melanoma skin cancer, compared with other bDMARDs. This potential signal needs to be replicated in other settings.

scholarly journals Non-melanoma Skin Cancer and Ten-year All-cause Mortality: A Population-based Cohort Study

2010 ◽  
Vol 90 (4) ◽  
pp. 362-367 ◽  
Author(s):  
A Jensen ◽  
AL Lamberg ◽  
JB Jacobsen ◽  
A Braae Olesen ◽  
HT Sørensen
Keyword(s):  
Cohort Study ◽  
Skin Cancer ◽  
Population Based ◽  
Non Melanoma Skin Cancer ◽  
All Cause Mortality ◽  
Melanoma Skin

scholarly journals Cancer risk in individuals with intellectual disability in Sweden: A population-based cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (10) ◽  
pp. e1003840
Author(s):  
Qianwei Liu ◽  
Hans-Olov Adami ◽  
Abraham Reichenberg ◽  
Alexander Kolevzon ◽  
Fang Fang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intellectual Disability ◽  
Cancer Risk ◽  
Reference Group ◽  
Population Based ◽  
Sibling Comparison ◽  
Increased Risk ◽  
Specific Cancer ◽  
Cancer Types ◽  
Risk Of Cancer

Background A knowledge gap exists about the risk of cancer in individuals with intellectual disability (ID). The primary aim of this study was to estimate the cancer risk among individuals with ID compared to individuals without ID. Methods and findings We conducted a population-based cohort study of all children live-born in Sweden between 1974 and 2013 and whose mothers were born in a Nordic country. All individuals were followed from birth until cancer diagnosis, emigration, death, or 31 December 2016 (up to age 43 years), whichever came first. Incident cancers were identified from the Swedish Cancer Register. We fitted Cox regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) as measures of cancer risk in relation to ID after adjusting for several potential confounders. We analyzed ID by severity, as well as idiopathic ID and syndromic ID separately. We performed a sibling comparison to investigate familial confounding. The study cohort included a total of 3,531,305 individuals, including 27,956 (0.8%) individuals diagnosed with ID. Compared with the reference group (individuals without ID and without a full sibling with ID), individuals with ID were in general more likely to be male. The median follow-up time was 8.9 and 23.0 years for individuals with ID and individuals without ID, respectively. A total of 188 cancer cases were identified among individuals with ID (incidence rate [IR], 62 per 1,000 person-years), and 24,960 among individuals in the reference group (IR, 31 per 1,000 person-years). A statistically significantly increased risk was observed for any cancer (HR 1.57, 95% CI 1.35–1.82; P < 0.001), as well as for several cancer types, including cancers of the esophagus (HR 28.4, 95% CI 6.2–130.6; P < 0.001), stomach (HR 6.1, 95% CI 1.5–24.9; P = 0.013), small intestine (HR 12.0, 95% CI 2.9–50.1; P < 0.001), colon (HR 2.0, 95% CI 1.0–4.1; P = 0.045), pancreas (HR 6.0, 95% CI 1.5–24.8; P = 0.013), uterus (HR 11.7, 95% CI 1.5–90.7; P = 0.019), kidney (HR 4.4, 95% CI 2.0–9.8; P < 0.001), central nervous system (HR 2.7, 95% CI 2.0–3.7; P < 0.001), and other or unspecified sites (HR 4.8, 95% CI 1.8–12.9; P = 0.002), as well as acute lymphoid leukemia (HR 2.4, 95% CI 1.3–4.4; P = 0.003) and acute myeloid leukemia (HR 3.0, 95% CI 1.4–6.4; P = 0.004). Cancer risk was not modified by ID severity or sex but was higher for syndromic ID. The sibling comparison showed little support for familial confounding. The main study limitations were the limited statistical power for the analyses of specific cancer types, and the potential for underestimation of the studied associations (e.g., due to potential underdetection or delayed diagnosis of cancer among individuals with ID). Conclusions In this study, we found that individuals with ID showed an increased risk of any cancer, as well as of several specific cancer types. These findings suggest that extended surveillance and early intervention for cancer among individuals with ID are warranted.

scholarly journals Risk of Non-Melanoma Skin Cancer in Association with Use of Hydrochlorothiazide-Containing Products in the United States

2021 ◽  
Author(s):  
Efe Eworuke ◽  
Nicole Haug ◽  
Marie Bradley ◽  
Austin Cosgrove ◽  
Tancy Zhang ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Incidence Rate ◽  
Proportional Hazards ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Mitigation Strategies ◽  
Converting Enzyme Inhibitors ◽  
Non Melanoma Skin Cancer ◽  
Increased Risk ◽  
Melanoma Skin

Abstract Background European studies reported an increased risk of non-melanoma skin cancer associated with hydrochlorothiazide (HCTZ)-containing products. We examined the risks of basal cell (BCC) and squamous cell carcinoma (SCC) associated with HCTZ compared to angiotensin-converting enzyme inhibitors (ACEIs) in a US population. Methods We conducted a retrospective cohort study in the US Food and Drug Administration’s Sentinel System. From the date of HCTZ or ACEI dispensing, patients were followed until a SCC or BCC diagnosis requiring excision or topical chemotherapy treatment on or within 30 days after the diagnosis date; or a censoring event. Using Cox proportional hazards regression models, we estimated the hazard ratios (HRs), overall and separately by age, sex, and race. We also examined site- and age-adjusted incidence rate ratios (IRRs) by cumulative HCTZ dose within the matched cohort. Results Among 5.2 million propensity-score matched HCTZ and ACEI users, the incidence rate (per 1,000 person-years) of BCC was 2.78 and 2.82 respectively, and 1.66 and 1.60 for SCC. Overall, there was no difference in risk between HCTZ and ACEIs for BCC (HR = 0.99, 95% CI = 0.97–1.00), but an increased risk for SCC (HR = 1.04, 95% CI = 1.02–1.06). HCTZ use was associated with higher risks of BCC (HR = 1.09, 95% CI = 1.07–1.11) and SCC (HR = 1.15, 95% CI = 1.12–1.17) among Caucasians. Cumulative HCTZ dose ≥50,000mg was associated with an increased risk of SCC in the overall population (IRR =1.19, 95% CI = 1.05–1.35) and among Caucasians (IRR = 1.27, 95% CI = 1.10–1.47). Conclusions Among Caucasians, we identified small increased risks of BCC and SCC with HCTZ compared to ACEI. Appropriate risk mitigation strategies should be taken while using HCTZ.

Is there a link between Non melanoma skin cancer and hydrochlorothiazide?

2021 ◽  
Vol 16 ◽  
Author(s):  
Luca Gallelli ◽  
Erika Cione ◽  
Antonio Siniscalchi ◽  
Gianfranco Vasta ◽  
Antonio Guerra ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Cell Carcinoma ◽  
Antihypertensive Drugs ◽  
Conditional Logistic Regression ◽  
Dose Response Relationship ◽  
Gender Stratification ◽  
Non Melanoma Skin Cancer ◽  
Increased Risk ◽  
Significant Difference ◽  
Melanoma Skin

Aims: Herein we evaluated the association between the use of Hydrochlorothiazide (HCTZ) and the risk of NMSC both, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Background: Even if the use of HCTZ is not related with the development of serious adverse drug reactions, in the last years, has been recorded the development of non-melanoma skin cancer (NMSC) in patients treated HCTZ, probably due to its photosensitizing capability. Objective: To evaluate the statistically significant difference (P<0.05) in the development of NMSC between HCTZ users and non-users, and the correlation (P<0.05) between HCTZ use and NMSC. Methods: We performed a retrospective study, in patients referred to general practitioners that, treated or not with antihypertensive drugs, developed or not skin cancer or NMSC. Controls were matched with test by age and sex. Using conditional logistic regression, we calculated odds ratios (ORs) for both skin cancer and NMSC associated with hydrochlorothiazide use. Results : In the present study, we enrolled 19,320 patients of these 10,110 (52.3%) received treatment with antihypertensive drugs. Of 10,110 patients, 3,870 were treated with HCTZ (38.3%). During the study, we failed to report an increased risk of NMSC in HCTZ-treated vs untreated patients. Gender stratification revealed an OR for NMSC of 1.36 for men and 0.56 for women. We did not find a dose-response relationship between HCTZ use and NMSC. Conclusions: In the present study we failed to report an association between the use of HCTZ and the development of NMSC.

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