Hydrochlorothiazide Use and Risk of Skin Cancer: A Population-Based Retrospective Cohort Study.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-11-01 DOI:10.1002/pds.70027

Avery Shuei-He Yang, Leila Djebarri, Chaw Ning Lee, Denis Granados, Mohamed Abdel Moneim, Shih-Chieh Shao, Swu-Jane Lin, Tzu-Chi Liao, Hung-Wei Lin, Edward Chia-Cheng Lai

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Abstract

Purpose: Hydrochlorothiazide (HCTZ) exposure has been linked to increased skin cancer in Caucasian (white) populations, especially squamous cell carcinoma (SCC), but not basal cell carcinoma (BCC). This study aimed to evaluate and compare skin cancer risks associated with HCTZ- and other antihypertensives use.

Methods: This retrospective cohort study utilized Taiwan's National Health Insurance Research Database. We identified patients aged 20 years and older, newly receiving antihypertensive medications between 2004 and 2015. We calculated the medication possession ratio (MPR) for the first 2 years of treatment to determine patient eligibility and treatment classification, whereby only patients with MPR above 80% were included. These were subsequently categorized by the type of antihypertensives they received, namely HCTZ, other thiazide diuretics, non-thiazide diuretics or non-diuretic antihypertensives. Cox proportional hazards model was used to evaluate skin cancer risks, and these were then classified as SCC or BCC.

Results: Our study included 41 086, 27 402, 19 613, and 856 782 patients receiving HCTZ, other thiazide diuretics, non-thiazide diuretics, and non-diuretic antihypertensives, respectively. We found BCC risks were similar when comparing HCTZ with other thiazides (adjusted hazard ratio: 0.84; 95% CI: 0.54-1.33), non-thiazide diuretics (0.93; 0.51-1.67), and non-diuretic antihypertensives (0.91; 0.66-1.26). We observed a higher SCC risk in the HCTZ group, compared to other thiazides (1.24; 0.74-2.08), non-thiazide diuretics (1.32; 0.70-2.51), and non-diuretic antihypertensives (1.23; 0.87-1.73), although the confidence intervals (CIs) were wide and crossed the null.

Conclusions: We concluded that skin cancer need not be of major concern to physicians when prescribing antihypertensives for an Asian population.

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使用氢氯噻嗪与患皮肤癌的风险：一项基于人群的回顾性队列研究。

目的：氢氯噻嗪（HCTZ）暴露与高加索人（白人）皮肤癌的增加有关，尤其是鳞状细胞癌（SCC），但与基底细胞癌（BCC）无关。本研究旨在评估和比较与使用 HCTZ 和其他降压药有关的皮肤癌风险：这项回顾性队列研究利用了台湾国民健康保险研究数据库。我们确定了 2004 年至 2015 年间新接受降压药治疗的 20 岁及以上患者。我们计算了治疗头两年的药物占有率（MPR），以确定患者的资格和治疗分类，只有MPR高于80%的患者才被纳入。随后，我们根据患者接受的降压药类型对其进行分类，即 HCTZ、其他噻嗪类利尿剂、非噻嗪类利尿剂或非利尿类降压药。采用 Cox 比例危险模型评估皮肤癌风险，然后将其分为 SCC 或 BCC：我们的研究分别纳入了 41 086 例、27 402 例、19 613 例和 856 782 例接受 HCTZ、其他噻嗪类利尿剂、非噻嗪类利尿剂和非利尿剂降压药治疗的患者。我们发现，HCTZ 与其他噻嗪类药物（调整后危险比：0.84；95% CI：0.54-1.33）、非噻嗪类利尿剂（0.93；0.51-1.67）和非利尿剂降压药（0.91；0.66-1.26）相比，BCC 风险相似。我们观察到，与其他噻嗪类药物（1.24；0.74-2.08）、非噻嗪类利尿剂（1.32；0.70-2.51）和非利尿剂类降压药（1.23；0.87-1.73）相比，HCTZ 组的 SCC 风险较高，但置信区间（CI）较宽，且跨越了零值：我们的结论是，医生在为亚洲人开具降压药处方时，不必过于担心皮肤癌。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.