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Chen R, Zhou S, Liu J, Li L, Su L, Li Y, Fang C, Zhang X, Luo F, Gao Q, Lin Y, Guo Z, Cao L, Xu X, Nie S. Renin-angiotensin system inhibitors and risk of hepatocellular carcinoma among patients with hepatitis B virus infection. CMAJ 2024; 196:E931-E939. [PMID: 39134317 PMCID: PMC11318981 DOI: 10.1503/cmaj.240003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a common cause of liver-related morbidity and mortality. Evidence suggests that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) decrease liver fibrosis, an intermediate step between liver injury and hepatocellular carcinoma (HCC). Our aim was to investigate the association between the use of ACEIs and ARBs on incident HCC and liver-related mortality among patients with HBV infection. METHODS We conducted a population-based study on a new-user cohort of patients seen at 24 hospitals across China. We included adult patients with HBV infection who started ACEIs or ARBs (ACEIs/ARBs), or calcium channel blockers or thiazide diuretics (CCBs/THZs) from January 2012 to December 2022. The primary outcome was incident HCC; secondary outcomes were liver-related mortality and new-onset cirrhosis. We used propensity score matching and Cox proportional hazards regression to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of study outcomes. RESULTS Among 32 692 eligible patients (median age 58 [interquartile range (IQR) 48-68] yr, and 18 804 male [57.5%]), we matched 9946 pairs of patients starting ACEIs/ARBs or CCBs/THZs. During a mean follow-up of 2.3 years, the incidence rate of HCC per 1000 person-years was 4.11 and 5.94 among patients who started ACEIs/ARBs and CCBs/THZs, respectively, in the matched cohort. Use of ACEIs/ARBs was associated with lower risks of incident HCC (HR 0.66, 95% CI 0.50-0.86), liver-related mortality (HR 0.77, 95% CI 0.64-0.93), and new-onset cirrhosis (HR 0.81, 95% CI 0.70-0.94). INTERPRETATION In this cohort of patients with HBV infection, new users of ACEIs/ARBs had a lower risk of incident HCC, liver-related mortality, and new-onset cirrhosis than new users of CCBs/THZs.
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Affiliation(s)
- Ruixuan Chen
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Shiyu Zhou
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Jiao Liu
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Lu Li
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Licong Su
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Yanqin Li
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Chuyao Fang
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaodong Zhang
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Fan Luo
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Qi Gao
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Yuxin Lin
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Zhixin Guo
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Lisha Cao
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Xu
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
| | - Sheng Nie
- State Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China
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Ho C, Ha NT, Youens D, Abhayaratna WP, Bulsara MK, Hughes JD, Mishra G, Pearson SA, Preen DB, Reid CM, Ruiter R, Saunders CM, Stricker BH, van Rooij FJA, Wright C, Moorin R. Association between long-term use of calcium channel blockers (CCB) and the risk of breast cancer: a retrospective longitudinal observational study protocol. BMJ Open 2024; 14:e080982. [PMID: 38458796 DOI: 10.1136/bmjopen-2023-080982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION Calcium channel blockers (CCB), a commonly prescribed antihypertensive (AHT) medicine, may be associated with increased risk of breast cancer. The proposed study aims to examine whether long-term CCB use is associated with the development of breast cancer and to characterise the dose-response nature of any identified association, to inform future hypertension management. METHODS AND ANALYSIS The study will use data from 2 of Australia's largest cohort studies; the Australian Longitudinal Study on Women's Health, and the 45 and Up Study, combined with the Rotterdam Study. Eligible women will be those with diagnosed hypertension, no history of breast cancer and no prior CCB use at start of follow-up (2004-2009). Cumulative dose-duration exposure to CCB and other AHT medicines will be captured at the earliest date of: the outcome (a diagnosis of invasive breast cancer); a competing risk event (eg, bilateral mastectomy without a diagnosis of breast cancer, death prior to any diagnosis of breast cancer) or end of follow-up (censoring event). Fine and Gray competing risks regression will be used to assess the association between CCB use and development of breast cancer using a generalised propensity score to adjust for baseline covariates. Time-varying covariates related to interaction with health services will also be included in the model. Data will be harmonised across cohorts to achieve identical protocols and a two-step random effects individual patient-level meta-analysis will be used. ETHICS AND DISSEMINATION Ethical approval was obtained from the following Human research Ethics Committees: Curtin University (ref No. HRE2022-0335), NSW Population and Health Services Research Ethics Committee (2022/ETH01392/2022.31), ACT Research Ethics and Governance Office approval under National Mutual Acceptance for multijurisdictional data linkage research (2022.STE.00208). Results of the proposed study will be published in high-impact journals and presented at key scientific meetings. TRIAL REGISTRATION NUMBER NCT05972785.
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Affiliation(s)
- Chau Ho
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Ninh Thi Ha
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - David Youens
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Walter P Abhayaratna
- Canberra Health Services, Canberra, Australian Capital Territory, Australia
- School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Max K Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Jeffery David Hughes
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
- PainChek, Sydney, New South Wales, Australia
| | - Gita Mishra
- School of Public Health, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Sallie-Anne Pearson
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The NHMRC Medicines Intelligence Centre of Research Excellence, Sydney, New South Wales, Australia
| | - David B Preen
- The NHMRC Medicines Intelligence Centre of Research Excellence, Sydney, New South Wales, Australia
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Christopher M Reid
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, Zuid-Holland, Netherlands
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, Zuid-Holland, Netherlands
| | - Christobel M Saunders
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Cameron Wright
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Fiona Stanley Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Rachael Moorin
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
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Rouette J, McDonald EG, Schuster T, Matok I, Brophy JM, Azoulay L. Thiazide Diuretics and Risk of Colorectal Cancer: A Population-Based Cohort Study. Am J Epidemiol 2024; 193:47-57. [PMID: 37579305 DOI: 10.1093/aje/kwad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 05/05/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023] Open
Abstract
Evidence from clinical trials and observational studies on the association between thiazide diuretics and colorectal cancer risk is conflicting. We aimed to determine whether thiazide diuretics are associated with an increased colorectal cancer risk compared with dihydropyridine calcium channel blockers (dCCBs). A population-based, new-user cohort was assembled using the UK Clinical Practice Research Datalink. Between 1990-2018, we compared thiazide diuretic initiators with dCCB initiators and estimated hazard ratios (HR) with 95% confidence intervals (CIs) of colorectal cancer using Cox proportional hazard models. Models were weighted using standardized morbidity ratio weights generated from calendar time-specific propensity scores. The cohort included 377,760 thiazide diuretic initiators and 364,300 dCCB initiators, generating 3,619,883 person-years of follow-up. Compared with dCCBs, thiazide diuretics were not associated with colorectal cancer (weighted HR = 0.97, 95% CI: 0.90, 1.04). Secondary analyses yielded similar results, although an increased risk was observed among patients with inflammatory bowel disease (weighted HR = 2.45, 95% CI: 1.13, 5.35) and potentially polyps (weighted HR = 1.46, 95% CI: 0.93, 2.30). Compared with dCCBs, thiazide diuretics were not associated with an overall increased colorectal cancer risk. While these findings provide some reassurance, research is needed to corroborate the elevated risks observed among patients with inflammatory bowel disease and history of polyps.
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McKerr N, Mohd-Sarip A, Dorrian H, Breen C, A James J, McQuaid S, Mills IG, McCloskey KD. CACNA1D overexpression and voltage-gated calcium channels in prostate cancer during androgen deprivation. Sci Rep 2023; 13:4683. [PMID: 36949059 PMCID: PMC10033880 DOI: 10.1038/s41598-023-28693-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/23/2023] [Indexed: 03/24/2023] Open
Abstract
Prostate cancer is often treated by perturbing androgen receptor signalling. CACNA1D, encoding CaV1.3 ion channels is upregulated in prostate cancer. Here we show how hormone therapy affects CACNA1D expression and CaV1.3 function. Human prostate cells (LNCaP, VCaP, C4-2B, normal RWPE-1) and a tissue microarray were used. Cells were treated with anti-androgen drug, Enzalutamide (ENZ) or androgen-removal from media, mimicking androgen-deprivation therapy (ADT). Proliferation assays, qPCR, Western blot, immunofluorescence, Ca2+-imaging and patch-clamp electrophysiology were performed. Nifedipine, Bay K 8644 (CaV1.3 inhibitor, activator), mibefradil, Ni2+ (CaV3.2 inhibitors) and high K+ depolarising solution were employed. CACNA1D and CaV1.3 protein are overexpressed in prostate tumours and CACNA1D was overexpressed in androgen-sensitive prostate cancer cells. In LNCaP, ADT or ENZ increased CACNA1D time-dependently whereas total protein showed little change. Untreated LNCaP were unresponsive to depolarising high K+/Bay K (to activate CaV1.3); moreover, currents were rarely detected. ADT or ENZ-treated LNCaP exhibited nifedipine-sensitive Ca2+-transients; ADT-treated LNCaP exhibited mibefradil-sensitive or, occasionally, nifedipine-sensitive inward currents. CACNA1D knockdown reduced the subpopulation of treated-LNCaP with CaV1.3 activity. VCaP displayed nifedipine-sensitive high K+/Bay K transients (responding subpopulation was increased by ENZ), and Ni2+-sensitive currents. Hormone therapy enables depolarization/Bay K-evoked Ca2+-transients and detection of CaV1.3 and CaV3.2 currents. Physiological and genomic CACNA1D/CaV1.3 mechanisms are likely active during hormone therapy-their modulation may offer therapeutic advantage.
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Affiliation(s)
- Niamh McKerr
- Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7AE, UK
| | - Adone Mohd-Sarip
- Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7AE, UK
| | - Hannah Dorrian
- Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7AE, UK
| | - Conor Breen
- Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7AE, UK
| | - Jacqueline A James
- Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7AE, UK
| | - Stephen McQuaid
- Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7AE, UK
| | - Ian G Mills
- Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7AE, UK
- Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Headley Way, OX3 9DU, UK
| | - Karen D McCloskey
- Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7AE, UK.
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Halámková J, Bohovicová L, Pehalová L, Kazda T, Goněc R, Staněk T, Mouková L, Adámková Krákorová D, Kozáková Š, Svoboda M, Demlová R, Gabrielová L, Hernychová L, Kiss I. The risk of second primary malignancies in colorectal cancer patients using calcium channel blockers. Sci Rep 2023; 13:3490. [PMID: 36859505 PMCID: PMC9977965 DOI: 10.1038/s41598-023-29535-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Calcium channel blockers are among the most commonly used agents in the treatment of cardiovascular diseases. There are several known side-effects associated with their long-term use, whereas other potential adverse effects are yet to be proven. This study aims to evaluate the association between calcium channel blockers exposure and the incidence of second primary malignancy. We established a cohort of 1401 patients with colorectal cancer diagnosed in our institution between January 2003 and December 2016. Patients were followed-up until December 2020. The tumor characteristics and basic clinical data including medication information were obtained from the hospital information system database. Second malignancy was detected in 301 patients (21.5%), and occurred in 27.8% of patients who used calcium channel blockers compared to only 19.9% among non-users. Their use was associated with an increased incidence of bladder cancer in particular. Subanalysis of patients with second malignancy displayed a higher proportion of right-sided colon cancer compared to rectal carcinoma in non-users. Survival analysis revealed significantly better outcomes in early-stage colorectal cancer patients without a history of calcium channel blockers treatment or second primary malignancy.
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Affiliation(s)
- Jana Halámková
- grid.419466.8Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lucia Bohovicová
- grid.419466.8Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lucie Pehalová
- grid.486651.80000 0001 2231 0366Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic ,grid.10267.320000 0001 2194 0956Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomáš Kazda
- grid.419466.8Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Roman Goněc
- grid.419466.8Department of Pharmacy, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Teodor Staněk
- grid.419466.8Department of General Surgical Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Surgical Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lucie Mouková
- grid.419466.8Department of Gynecologic Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Dagmar Adámková Krákorová
- grid.419466.8Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Šárka Kozáková
- grid.412554.30000 0004 0609 2751Department of Pharmacy, University Hospital Brno, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Svoboda
- grid.419466.8Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Regina Demlová
- grid.10267.320000 0001 2194 0956Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic ,grid.419466.8Clinical Trial Unit, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Lucie Gabrielová
- grid.10267.320000 0001 2194 0956Department of Surgical Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic ,grid.419466.8Department of Breast, Skin and Oncoplastic Surgery, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Lenka Hernychová
- grid.419466.8Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Igor Kiss
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic. .,Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic. .,Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 656 53, Brno, Czech Republic.
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Rotshild V, Rabkin N, Matok I. The Risk for Prostate Cancer With Calcium Channel Blockers: A Systematic Review, Meta-Analysis, and Meta-Regression. Ann Pharmacother 2023; 57:16-28. [PMID: 35645169 DOI: 10.1177/10600280221098121] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND For decades, conflicting results were published regarding the increased risk of Prostate cancer (PCa) among calcium channel blocker (CCB) users. OBJECTIVE We aimed to evaluate the association between PCa and CCB exposure and assess moderating factors. METHODS We performed a systematic literature search in PubMed, Embase, and Cochrane databases for observational and randomized studies published until November 2020 with no language limitations, including data on the risk for PCa in CCB users compared with non-CCB users. We applied a random-effects model meta-analysis to pool results. In addition, we investigated potential moderating factors, such as CCB type, study type, participants' age, and duration of exposure, using meta-regression methods. RESULTS In our primary analysis, we included 18 studies. A statistically significant 5% increase in the risk for PCa was observed among CCB users (risk ratio [RR] = 1.05; 95% confidence interval [CI]: 1.01-1.10), with no significant association between the duration of exposure to CCBs and the risk for PCa (RR = 1.08; 95% CI: 0.98-1.19 for exposure for < 5years and RR = 1.01; 95% CI: 0.9-1.14 for exposure ≥ 5 years). The association remained statistically significant for the subgroup of dihydropyridines (RR = 1.13; 95% CI: 1.05-1.22). In addition, the association was not influenced by participants' age. CONCLUSION AND RELEVANCE CCBs are an important modality in treating hypertension. The 5% increased risk observed in the current meta-analysis could be influenced by residual confounding factors and should not affect hypertension treatment guidelines until more studies provide additional clinical information.
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Affiliation(s)
- Victoria Rotshild
- Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Natalie Rabkin
- Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ilan Matok
- Pharmacoepidemiology Research Lab, Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Zhang Y, Song M, Chan AT, Meyerhardt JA, Willett WC, Giovannucci EL. Long-term use of antihypertensive medications, hypertension and colorectal cancer risk and mortality: a prospective cohort study. Br J Cancer 2022; 127:1974-1982. [PMID: 36138074 PMCID: PMC9681847 DOI: 10.1038/s41416-022-01975-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Hypertension and the use of antihypertensive medications have been intensively investigated in relation to colorectal cancer (CRC). Prior epidemiologic studies have not been able to examine this topic with adequate confounding control and follow-up time, or disentangle the effects of antihypertensive agents and hypertension. METHODS Eligible participants in the Nurses' Health Study and Health Professionals Follow-up Study were followed for up to 28 years, with repeat assessments of exposures. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. RESULTS In fully adjusted analyses based on both new-user and prevalent-user designs, there was no association between the use of beta-blockers, calcium-channel blockers, thiazide diuretics, angiotensin-converting enzyme inhibitors, furosemide, other antihypertensive drugs and CRC risk and mortality reached the statistically significant threshold after Bonferroni correction. The results remained similar in sensitivity analyses among participants with hypertension. Before Bonferroni correction, suggestive associations between beta-blocker use and CRC risk and between furosemide use and CRC-specific mortality were observed specifically in analyses using a new-user design. Hypertension was not associated with CRC risk in analyses based on both new-user and prevalent-user designs. CONCLUSIONS Hypertension and long-term use of major classes of antihypertensive medications are unlikely to be associated with CRC risk and mortality.
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Affiliation(s)
- Yin Zhang
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Mingyang Song
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Andrew T Chan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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8
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Lepri G, Catalano M, Bellando-Randone S, Pillozzi S, Giommoni E, Giorgione R, Botteri C, Matucci-Cerinic M, Antonuzzo L, Guiducci S. Systemic Sclerosis Association with Malignancy. Clin Rev Allergy Immunol 2022; 63:398-416. [PMID: 36121543 DOI: 10.1007/s12016-022-08930-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 12/17/2022]
Abstract
The association of systemic sclerosis (SSc) and cancer is well known from several decades suggesting common genetic and environmental risk factors involved in the development of both diseases. Immunosuppressive drugs widely used in SSc may increase the risk of cancer occurrence and different SSc clinical and serological features identify patients at major risk to develop malignancy. In this context, among serological features, presence of anti-RNA polymerase III and anti-topoisomerase I autoantibodies seems to increase cancer frequency in SSc patients (particularly lung and breast cancers). Lung fibrosis and a long standing SSc pulmonary involvement have been largely proposed as lung cancer risk factors, and the exposure to cyclophosphamide and an upper gastrointestinal involvement have been traditionally linked to bladder and oesophagus cancers, respectively. Furthermore, immune checkpoint inhibitors used for cancer therapy can induce immune-related adverse events, which are more frequent and severe in patients with pre-existing autoimmune diseases such as SSc. The strong association between SSc and cancer occurrence steers clinicians to carefully survey SSc patients performing periodical malignancy screening. In the present review, the most relevant bilateral relationships between SSc and cancer will be addressed.
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Affiliation(s)
- Gemma Lepri
- Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology, AOUC & Scleroderma Unit, Florence, Italy.
| | - Martina Catalano
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Silvia Bellando-Randone
- Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology, AOUC & Scleroderma Unit, Florence, Italy
| | - Serena Pillozzi
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Elisa Giommoni
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | | | - Cristina Botteri
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology, AOUC & Scleroderma Unit, Florence, Italy.,Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy
| | - Lorenzo Antonuzzo
- Medical Oncology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Serena Guiducci
- Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology, AOUC & Scleroderma Unit, Florence, Italy
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9
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Chen YC, Wu CT, Chen JH, Tsai CF, Wu CY, Chang PC, Yeh WL. Diltiazem inhibits breast cancer metastasis via mediating growth differentiation factor 15 and epithelial-mesenchymal transition. Oncogenesis 2022; 11:48. [PMID: 35963873 PMCID: PMC9376069 DOI: 10.1038/s41389-022-00423-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 12/22/2022] Open
Abstract
Migration and metastasis commonly happen to triple-negative breast cancer (TNBC) patients with advanced diseases. In many studies, it has been suggested that epithelial-mesenchymal transition (EMT) is one of the key mechanisms triggering cancer metastasis. Accumulating evidence has proven that calcium channel blockers mediate cell motility. Therefore, we attempt to investigate the effects of diltiazem, which has been selected from several FDA-approved clinical calcium channel blockers, on EMT in TNBC. By using both mouse and human TNBC cell lines, we found that diltiazem decreases colony formation and cell migration in breast cancer cells. The expression of epithelial markers such as E-cadherin and ZO-1 were increased dose-dependently by diltiazem, while mesenchymal markers such as Snail and Twist were decreased. In addition, we found that the expression of growth differentiation factor-15 (GDF-15) was also increased by diltiazem. Administering recombinant GDF-15 also reverses EMT, inhibits colony formation and migration in breast cancer cells. Moreover, treatment with diltiazem in tumor-bearing mice also decreases cancer metastasis and nodule formation, with more GDF-15 expression in diltiazem-treated mice than saline-treated mice, respectively. These findings suggest that diltiazem regulates EMT and cell motility through elevating GDF-15 expression in breast cancers in vitro and in vivo.
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Affiliation(s)
- Yen-Chang Chen
- Institute of New Drug Development, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan
| | - Chen-Teng Wu
- Department of Surgery, China Medical University Hospital, No. 2, Yude Road, Taichung, 404332, Taiwan
| | - Jia-Hong Chen
- Department of General Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 88, Sec. 1, Fengxing Road, Taichung, 427213, Taiwan
| | - Cheng-Fang Tsai
- Department of Medical Laboratory Science and Biotechnology, Asia University, No.500 Lioufeng Road, Taichung, 413305, Taiwan
| | - Chen-Yun Wu
- Institute of New Drug Development, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan
| | - Pei-Chun Chang
- Department of Bioinformatics and Medical Engineering, Asia University, No.500 Lioufeng Road, Taichung, 413305, Taiwan
| | - Wei-Lan Yeh
- Institute of New Drug Development, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan. .,Department of Biochemistry, School of Medicine, China Medical University, No.91 Hsueh-Shih Road, Taichung, 404333, Taiwan.
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10
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Anti-hypertensive medications and risk of colorectal cancer: a systematic review and meta-analysis. Cancer Causes Control 2022; 33:801-812. [PMID: 35314908 DOI: 10.1007/s10552-022-01570-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Antihypertensive medications may impact colorectal cancer risk. We conducted a systematic review and meta-analysis of associations, with colorectal cancer risk, of five classes of antihypertensive medications: angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs), and diuretics. METHODS A systematic search was conducted in MEDLINE, Embase, Web of Science, and the Cochrane library to identify relevant studies evaluating associations of ACEIs, ARBs, BBs, CCBs, and diuretics with colorectal cancer risk. Meta-analytic risk ratios (RRs) and corresponding 95% confidence intervals (95% CIs) were calculated using the inverse variance method. RESULTS No overall significant associations with colorectal cancer risk were observed; ACEIs (5 studies) RR 1.05, 95% CI 0.91-1.23, ARBs (5 studies) RR 0.94, 95% CI 0.80-1.11, BBs (4 studies) RR 1.00, 95% CI 0.92-1.08, CCBs (4 studies) RR 1.02, 95% CI 0.88-1.18, and diuretics (6 studies) RR 1.02, 95% CI 0.90-1.17. There was considerable heterogeneity across studies, partly explained by differences in study design and location. When stratified by study location, there was significantly reduced colorectal cancer risk for ARB use in Asian populations (2 studies, RR 0.69, 95% CI 0.58-0.83). CONCLUSION No significant colorectal cancer risk with ACEIs, BBs, CCBs, or diuretics was observed. ARB use may be associated with decreased risk of colorectal cancer in Asian populations, although additional studies in diverse populations are needed to confirm associations and help understand possible reasons for geographical differences.
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11
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Chan TH, Tsoi MF, Yung Cheung BM. Cancer Risk of Angiotensin II Receptor Blocker Valsartan: A Population-based Study. J Cardiovasc Pharmacol 2022; 79:577-582. [PMID: 35020688 DOI: 10.1097/fjc.0000000000001217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Nitrosamine contamination of generic valsartan was found in 2018. This study aimed to investigate whether long-term use of valsartan increases cancer risk. Patients prescribed valsartan or amlodipine (control group) from 1 January 1, 2003, to June 30, 2010, were identified using the Clinical Data Analysis and Reporting System of the Hong Kong Hospital Authority, a territory-wide database in Hong Kong. Patients previously diagnosed with cancer, prescribed both medications, taking the medication, or followed up for <1 year were excluded. Cancer incidence, adjusted for age, sex, and Charlson Comorbidity Index, was the primary outcome and was estimated using Poisson regression in R version 3.6.1. Among 5023 valsartan users and 3692 amlodipine users, 887 and 740 were diagnosed with cancers during median follow-up periods of 10.97 and 12.12 years, respectively. The adjusted incidence of cancer in valsartan and amlodipine users was 165.29 (95% confidence interval 154.76-175.53) and 180.12 (167.35-193.67) per 10,000 person-years, respectively. The cancer incidence rate ratio of valsartan relative to amlodipine was 0.94 (0.88-1.01). Adjusted incidence rate ratios of valsartan relative to amlodipine were significant for breast cancer (0.63, 0.46-0.86) only. Our findings do not suggest an increase in incidence of cancer with long-term valsartan use. The duration of follow-up of more than 10 years of the study provides the reassurance that an increase in cancer risk is unlikely. Further studies are needed to elucidate the long-term effect of valsartan use on the risk of specific types of cancer.
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Affiliation(s)
- Tak Hon Chan
- Department of Medicine, The University of Hong Kong
| | - Man Fung Tsoi
- Department of Medicine, The University of Hong Kong
- Division of Musculoskeletal and Dermatological Sciences, Center of Epidemiology Versus Arthritis, The University of Manchester
| | - Bernard Man Yung Cheung
- Department of Medicine, The University of Hong Kong
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong; and
- Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Hong Kong, China
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12
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Deng Y, Xie Y, Wang M, Xu P, Wei B, Li N, Wu Y, Yang S, Zhou L, Hao Q, Lyu L, Zhang D, Dai Z. Effects of Antihypertensive Drugs Use on Risk and Prognosis of Colorectal Cancer: A Meta-Analysis of 37 Observational Studies. Front Pharmacol 2022; 12:670657. [PMID: 35087400 PMCID: PMC8789244 DOI: 10.3389/fphar.2021.670657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 12/21/2021] [Indexed: 01/17/2023] Open
Abstract
Background: Antihypertensive drugs might play a key role in the risk and poor prognosis of colorectal cancer. However, current epidemiologic evidence remains inconsistent. The aim of this study is to quantify the association between antihypertensive drugs and colorectal cancer. Methods: To identify available studies, we systematically searched electronic databases: PubMed, Web of Science, Embase, Cochrane Library. The risk estimates and their corresponding 95% confidence intervals (CIs) were collected and analyzed by using random-effects models. Heterogeneity test and sensitivity analysis were also performed. Results: Overall, 37 observational studies were included in this analysis (26 studies with cohort design, three studies with nested case-control design, and 8 studies with case-control design). Antihypertensive drugs did not present a significant effect on the risk or overall survival of patients with colorectal cancer [Risk ratio (RR) = 1.00, 95% CI: 0.95-1.04; Hazard ratio (HR) = 0.93, 95% CI: 0.84-1.02]. In the subgroup analysis, diuretics use was significantly associated with a worse overall survival of patients with colorectal cancer (HR = 1.27; 95% CI: 1.14-1.40). However, use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers was associated with improved progression-free survival of patients who suffered from colorectal cancer (HR = 0.83; 95% CI: 0.72-0.95). Conclusion: Antihypertensive drug usage did not influence the risk and overall survival of patients with colorectal cancer in general. Further investigation reminded us that diuretics use might reduce the overall survival time in colorectal cancer patients, whereas those who took Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers had a longer progression-free survival.
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Affiliation(s)
- Yujiao Deng
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuxiu Xie
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng Wang
- Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Peng Xu
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bajin Wei
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Na Li
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Wu
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Si Yang
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Linghui Zhou
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qian Hao
- Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lijuan Lyu
- Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dai Zhang
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhijun Dai
- Department of Breast Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, the 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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13
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Wu CN, Wu SC, Chen WC, Yang YH, Chin JC, Chien CY, Fang FM, Li SH, Luo SD, Chiu TJ. Angiotensin II receptor blockers and oral squamous cell carcinoma survival: A propensity-score-matched cohort study. PLoS One 2021; 16:e0260772. [PMID: 34855858 PMCID: PMC8638984 DOI: 10.1371/journal.pone.0260772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 11/16/2021] [Indexed: 01/05/2023] Open
Abstract
Objectives Angiotensin II receptor blockers (ARBs) improve the survival rates of patients with various cancers. However, it remains unclear whether ARBs confer a survival benefit on patients with oral squamous cell carcinoma (OSCC). Here, we assessed the associations between ARB use and survival in patients with OSCC of different stages. Materials and methods This was a 10-year retrospective cohort study of OSCC patients. We enrolled 7,558 patients diagnosed with oral cancer between January 2007 and December 2017 whose details had been entered into the Chang Gung Research Database. Seven hundred and fourteen patients were recruited from the Chang Gung Research Database after performing 1:1 propensity score-matching between ARB users and non-users. Cox’s regression models with adjusted covariates were employed to detect factors influencing the survival rates of patients with OSCC. Results Kaplan-Meier analysis revealed that the overall survival (OS) rate of 180-day ARB users increased (p = 0.038). Cox’s regression models indicated that ARB use, younger patients, early-stage OSCC, and patients without diabetes mellitus were independently prognostic of improved OS. Increased OS was more prominent in 180-day ARB users in stage III, Iva, and IVb categories. Conclusions ARB use for more than 180 days is associated with an increased survival rate and is a positive, independent prognostic factor in patients with OSCC. A further two-arm study should be conducted to confirm the clinical usefulness of ARBs in OSCC patients.
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Affiliation(s)
- Ching-Nung Wu
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shao-Chun Wu
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Chih Chen
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jo-Chi Chin
- Department of Anesthesiology, Park One International Hospital, Kaohsiung, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Min Fang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail: (TJC); (SDL)
| | - Tai-Jan Chiu
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail: (TJC); (SDL)
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14
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Chen YC, Chen JH, Tsai CF, Wu CT, Wu MH, Chang PC, Yeh WL. Nicardipine Inhibits Breast Cancer Migration via Nrf2/HO-1 Axis and Matrix Metalloproteinase-9 Regulation. Front Pharmacol 2021; 12:710978. [PMID: 34483918 PMCID: PMC8414136 DOI: 10.3389/fphar.2021.710978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/07/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Metastasis represents an advanced stage of cancers, and matrix metalloproteinases are critical regulators. Calcium signal is crucial for appropriate cell behaviors. The efficacy and effects of calcium channel blockers in treating cancers are individually differ from each other. Here, we attempt to investigate the effects of nicardipine, a FDA-approved calcium channel blocker, in advanced breast cancers. Methods: We analyzed the influence of nicardipine on the colony-forming ability of triple negative breast cancer cell lines. Using cell culture inserts, cell migration was also examined. The expression of regulatory proteins was evaluated by real-time PCR, Western blot, and ELISA. Results: We have confirmed that nicardipine inhibits the breast cancer cells migration and colony formation. In addition, we also revealed that nicardipine increases the Nrf2 and HO-1 expression. The inhibition of HO-1 abrogates nicardipine-reduced matrix metalloproteinase-9 expression. Moreover, the end products of HO-1, namely, CO, Fe2+, and biliverdin (will converted to bilirubin), also decreases the expression of matrix metalloproteinase-9. Conclusion: These findings suggest that nicardipine-mediated matrix metalloproteinase-9 reduction is regulated by Nrf2/HO-1 axis and its catalytic end products. Therefore, nicardipine may be a potential candidate for repurposing against advanced breast cancers.
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Affiliation(s)
- Yen-Chang Chen
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan.,Institute of New Drug Development, China Medical University, Taichung, Taiwan
| | - Jia-Hong Chen
- Department of General Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Cheng-Fang Tsai
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
| | - Chen-Teng Wu
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Miao-Hsiang Wu
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
| | - Pei-Chun Chang
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Wei-Lan Yeh
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan.,Institute of New Drug Development, China Medical University, Taichung, Taiwan.,Department of Biochemistry, School of Medicine, China Medical University, Taichung, Taiwan
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15
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Santiago CN, Rifkin S, Drewes J, Mullin G, Spence E, Hylind LM, Gills JJ, Kafonek D, Cromwell DM, Luna LL, Giardello F, Sears CL. Self-reported Metabolic Risk Factor Associations with Adenomatous, Sessile Serrated, and Synchronous Adenomatous and Sessile Serrated Polyps. Cancer Prev Res (Phila) 2021; 14:697-708. [PMID: 33947705 PMCID: PMC8295232 DOI: 10.1158/1940-6207.capr-20-0664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/04/2021] [Accepted: 04/27/2021] [Indexed: 01/03/2023]
Abstract
Studies have found a positive association between metabolic risk factors, such as obesity and diabetes, and adenomatous polyps (AP). However, fewer studies have assessed the association between sessile serrated polyps (SSP) or synchronous diagnosis of APs and SSPs (synch polyps). Study participants (N = 1,370; ages 40-85) undergoing screening colonoscopy were enrolled between August 2016 and February 2020. Self-reported metabolic risk factors, including diabetes, hypertension, hyperlipidemia, and overweight/obesity, were evaluated for associations with new diagnoses of APs, SSPs, and synch polyps at the present colonoscopy. Average participant age was 60.73 ± 8.63 (SD) years; 56.7% were female and 90.9% white. In an assessment of individual metabolic risk factors, adjusted for age, sex, race, and smoking status, increased body mass index (BMI; overweight or obese vs. normal BMI of <25 kg/m2) was associated with an increased odds for new onset of colon APs (P trend < 0.001) as was a diagnosis of diabetes [adjusted conditional OR (aCOR) = 1.59 (1.10-2.29)]. No associations were seen between the metabolic risk factors and onset of SSPs. Being obese or hypertensive each increased the odds of new onset of synch polyps with aCOR values of 2.09 (1.01-4.32) and 1.79 (1.06-3.02), respectively. Self-reported risk factors may help assess polyp type risk. Because SSPs and synch polyps are rare, larger studies are needed to improve our understanding of the contribution of these factors to polyp risk. These data lead us to hypothesize that differences in observed metabolic risk factors between polyp types reflect select metabolic impact on pathways to colorectal cancer. PREVENTION RELEVANCE: Self-reported medical history provides valuable insight into polyp risk, potentially enabling the use of larger retrospective studies of colonoscopy populations to assess knowledge gaps. More aggressive colonoscopy screening, critical to colorectal cancer prevention, may be considered in populations of individuals with metabolic risk factors and modifiable lifestyle risk factors.
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Affiliation(s)
- Celina N. Santiago
- Division of Infectious Diseases, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Samara Rifkin
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julia Drewes
- Division of Infectious Diseases, Johns Hopkins Medicine, Baltimore, MD, USA
- Bloomberg-Kimmel Institute of Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerard Mullin
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Emma Spence
- Division of Infectious Diseases, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Linda M. Hylind
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joell J. Gills
- Bloomberg-Kimmel Institute of Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David Kafonek
- Green Spring Station Endoscopy, Lutherville-Timonium, MD, USA
| | | | - Louis La Luna
- Digestive Disease Associates, Reading, Wyomissing, PA, USA
| | - Francis Giardello
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cynthia L. Sears
- Division of Infectious Diseases, Johns Hopkins Medicine, Baltimore, MD, USA
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Bloomberg-Kimmel Institute of Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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16
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Carlos-Escalante JA, de Jesús-Sánchez M, Rivas-Castro A, Pichardo-Rojas PS, Arce C, Wegman-Ostrosky T. The Use of Antihypertensive Drugs as Coadjuvant Therapy in Cancer. Front Oncol 2021; 11:660943. [PMID: 34094953 PMCID: PMC8173186 DOI: 10.3389/fonc.2021.660943] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/19/2021] [Indexed: 12/23/2022] Open
Abstract
Cancer is a complex group of diseases that constitute the second largest cause of mortality worldwide. The development of new drugs for treating this disease is a long and costly process, from the discovery of the molecule through testing in phase III clinical trials, a process during which most candidate molecules fail. The use of drugs currently employed for the management of other diseases (drug repurposing) represents an alternative for developing new medical treatments. Repurposing existing drugs is, in principle, cheaper and faster than developing new drugs. Antihypertensive drugs, primarily belonging to the pharmacological categories of angiotensin-converting enzyme inhibitors, angiotensin II receptors, direct aldosterone antagonists, β-blockers and calcium channel blockers, are commonly prescribed and have well-known safety profiles. Additionally, some of these drugs have exhibited pharmacological properties useful for the treatment of cancer, rendering them candidates for drug repurposing. In this review, we examine the preclinical and clinical evidence for utilizing antihypertensive agents in the treatment of cancer.
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Affiliation(s)
- José A. Carlos-Escalante
- Plan de Estudios Combinados En Medicina (PECEM) (MD/PhD), Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Marcela de Jesús-Sánchez
- Facultad de Ciencias Biológicas y Agropecuarias, Universidad Veracruzana, Orizaba-Córdoba, Mexico
| | - Alejandro Rivas-Castro
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | | | - Claudia Arce
- Medical Oncology/Breast Tumors, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Talia Wegman-Ostrosky
- Basic Research Subdirection, Instituto Nacional de Cancerología, Mexico City, Mexico
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17
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Whelton SP, Berning P, Blumenthal RS, Marshall CH, Martin SS, Mortensen MB, Blaha MJ, Dzaye O. Multidisciplinary prevention and management strategies for colorectal cancer and cardiovascular disease. Eur J Intern Med 2021; 87:3-12. [PMID: 33610416 DOI: 10.1016/j.ejim.2021.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/09/2021] [Accepted: 02/06/2021] [Indexed: 02/06/2023]
Abstract
Colorectal cancer (CRC) and cardiovascular disease (CVD) are leading causes of morbidity and mortality worldwide. Their numerous shared and modifiable risk factors underscore the importance of effective prevention strategies for these largely preventable diseases. Conventionally regarded as separate disease entities, clear pathophysiological links and overlapping risk factors represent an opportunity for synergistic collaborative efforts of oncologists and cardiologists. In addition, current CRC treatment approaches can exert cardiotoxicity and thus increase CVD risk. Given the complex interplay of both diseases and increasing numbers of CRC survivors who are at increased risk for CVD, multidisciplinary cardio-oncological approaches are warranted for optimal patient care from primary prevention to acute disease treatment and long-term surveillance.
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Affiliation(s)
- Seamus P Whelton
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Philipp Berning
- Department of Hematology and Oncology, University Hospital Muenster, Muenster, Germany
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Catherine Handy Marshall
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Seth S Martin
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Martin Bødtker Mortensen
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Omar Dzaye
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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18
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Moon S, Lee HY, Jang J, Park SK. Association Between Angiotensin II Receptor Blockers and the Risk of Lung Cancer Among Patients With Hypertension From the Korean National Health Insurance Service-National Health Screening Cohort. J Prev Med Public Health 2020; 53:476-486. [PMID: 33296588 PMCID: PMC7733756 DOI: 10.3961/jpmph.20.405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/16/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives: The objective of this study was to estimate the risk of lung cancer in relation to angiotensin II receptor blocker (ARB) use among patients with hypertension from the Korean National Health Insurance Service-National Health Screening Cohort. Methods: We conducted a retrospective cohort study of patients with hypertension who started to take antihypertensive medications and had a treatment period of at least 6 months. We calculated the weighted hazard ratios (HRs) and their 95% confidence intervals (CIs) of lung cancer associated with ARB use compared with calcium channel blocker (CCB) use using inverse probability treatment weighting. Results: Among a total of 60 469 subjects with a median follow-up time of 7.8 years, 476 cases of lung cancer were identified. ARB use had a protective effect on lung cancer compared with CCB use (HR, 0.75; 95% CI, 0.59 to 0.96). Consistent findings were found in analyses considering patients who changed or discontinued their medication (HR, 0.50; 95% CI, 0.32 to 0.77), as well as for women (HR, 0.56; 95% CI, 0.34 to 0.93), patients without chronic obstructive pulmonary disease (HR, 0.75; 95% CI, 0.56 to 1.00), never-smokers (HR, 0.64; 95% CI, 0.42 to 0.99), and non-drinkers (HR, 0.69; 95% CI, 0.49 to 0.97). In analyses with different comparison antihypertensive medications, the overall protective effects of ARBs on lung cancer risk remained consistent. Conclusions: The results of the present study suggest that ARBs could decrease the risk of lung cancer. More evidence is needed to establish the causal effect of ARBs on the incidence of lung cancer.
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Affiliation(s)
- Sungji Moon
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea.,Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea
| | - Hae-Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jieun Jang
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea.,Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
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19
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Fu EL, Clase CM, Evans M, Lindholm B, Rotmans JI, Dekker FW, van Diepen M, Carrero JJ. Comparative Effectiveness of Renin-Angiotensin System Inhibitors and Calcium Channel Blockers in Individuals With Advanced CKD: A Nationwide Observational Cohort Study. Am J Kidney Dis 2020; 77:719-729.e1. [PMID: 33246024 DOI: 10.1053/j.ajkd.2020.10.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/15/2020] [Indexed: 01/09/2023]
Abstract
RATIONALE & OBJECTIVE It is unknown whether initiating renin-angiotensin system (RAS) inhibitor therapy in patients with advanced chronic kidney disease (CKD) is superior to alternative antihypertensive agents such as calcium channel blockers (CCBs). We compared the risks for kidney replacement therapy (KRT), mortality, and major adverse cardiovascular events (MACE) in patients with advanced CKD in routine nephrology practice who were initiating either RAS inhibitor or CCB therapy. STUDY DESIGN Observational study in the Swedish Renal Registry, 2007 to 2017. SETTINGS & PARTICIPANTS 2,458 new users of RAS inhibitors and 2,345 CCB users with estimated glomerular filtration rates<30mL/min/1.73m2 (CKD G4-G5 without KRT) who were being followed up by a nephrologist. As a positive control cohort, new users of the same drugs with CKD G3 (estimated glomerular filtration rate, 30-60mL/min/1.73m2) were evaluated. EXPOSURES RAS inhibitor versus CCB therapy initiation. OUTCOME Initiation of KRT (maintenance dialysis or transplantation), all-cause mortality, and MACE (composite of cardiovascular death, myocardial infarction, or stroke). ANALYTICAL APPROACH HRs with 95% CIs were estimated using propensity score-weighted Cox proportional hazards regression adjusting for demographic, clinical, and laboratory covariates. RESULTS Median age was 74 years, 38% were women, and median follow-up was 4.1 years. After propensity score weighting, there was significantly lower risk for KRT after new use of RAS inhibitors compared with new use of CCBs (adjusted HR, 0.79 [95% CI, 0.69-0.89]) but similar risks for mortality (adjusted HR, 0.97 [95% CI, 0.88-1.07]) and MACE (adjusted HR, 1.00 [95% CI, 0.88-1.15]). Results were consistent across subgroups and in as-treated analyses. The positive control cohort of patients with CKD G3 showed similar KRT risk reduction (adjusted HR, 0.67 [95% CI, 0.56-0.80]) with RAS inhibitor therapy compared with CCBs. LIMITATIONS Potential confounding by indication. CONCLUSIONS Our findings provide evidence from real-world clinical practice that initiation of RAS inhibitor therapy compared with CCBs may confer kidney benefits among patients with advanced CKD, with similar cardiovascular protection.
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Affiliation(s)
- Edouard L Fu
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Catherine M Clase
- Department of Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Marie Evans
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Lindholm
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Joris I Rotmans
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Merel van Diepen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Juan-Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
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20
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Renin-Angiotensin-Aldosterone System-based Antihypertensive Agents and the Risk of Colorectal Cancer Among Medicare Beneficiaries. Epidemiology 2020; 30:867-875. [PMID: 31348009 DOI: 10.1097/ede.0000000000001065] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Biologic evidence suggests that angiotensin II may play a role in tumor progression or growth. We compared the short-term colorectal cancer (CRC) risk among initiators of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) versus guideline-recommended clinical alternatives (beta blockers, calcium channel blockers [CCB], and thiazides). METHODS We conducted a new-user cohort study on U.S. Medicare beneficiaries aged over 65 years, who initiated antihypertensive monotherapy during 2007-2013 and were free of cancer diagnosis before drug initiation. Follow-up began 6 months postinitiation to allow time for the diagnostic delay. We estimated hazard ratios (HR) with 95% confidence intervals (CI) using propensity score weighted Cox regression, overall and stratified by time since drug initiation, and 5-year cumulative risk differences (RD) using Kaplan-Meier estimator. We assessed the potential for unmeasured confounding using supplemental data from Medicare Current Beneficiary Survey. RESULTS For analyses without censoring for treatment changes, we observed 532 CRC events among 111,533 ACEI/ARB initiators. After a median follow-up of 2.2 years (interquartile range: 1.0-3.7), CRC risk was similar between ACEI/ARB and active comparators, with adjusted HRs of 1.0 (95% CI = 0.85, 1.1) for ACEI/ARB versus beta blockers, 1.2 (95% CI = 0.97, 1.4) for ACEI/ARB versus CCB and 1.0 (95% CI = 0.80, 1.3) for ACEI/ARB versus thiazide. Five-year RDs and as-treated analyses, which censored follow-up at medication changes, produced similar findings. CONCLUSIONS Based on real-world antihypertensive utilization patterns in Medicare beneficiaries, our study suggests no association between ACEI/ARB initiation and the short-term CRC risk.
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21
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Capatina AL, Lagos D, Brackenbury WJ. Targeting Ion Channels for Cancer Treatment: Current Progress and Future Challenges. Rev Physiol Biochem Pharmacol 2020; 183:1-43. [PMID: 32865696 DOI: 10.1007/112_2020_46] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Ion channels are key regulators of cancer cell pathophysiology. They contribute to a variety of processes such as maintenance of cellular osmolarity and membrane potential, motility (via interactions with the cytoskeleton), invasion, signal transduction, transcriptional activity and cell cycle progression, leading to tumour progression and metastasis. Ion channels thus represent promising targets for cancer therapy. Ion channels are attractive targets because many of them are expressed at the plasma membrane and a broad range of existing inhibitors are already in clinical use for other indications. However, many of the ion channels identified in cancer cells are also active in healthy normal cells, so there is a risk that certain blockers may have off-target effects on normal physiological function. This review describes recent research advances into ion channel inhibitors as anticancer therapeutics. A growing body of evidence suggests that a range of existing and novel Na+, K+, Ca2+ and Cl- channel inhibitors may be effective for suppressing cancer cell proliferation, migration and invasion, as well as enhancing apoptosis, leading to suppression of tumour growth and metastasis, either alone or in combination with standard-of-care therapies. The majority of evidence to date is based on preclinical in vitro and in vivo studies, although there are several examples of ion channel-targeting strategies now reaching early phase clinical trials. Given the strong links between ion channel function and regulation of tumour growth, metastasis and chemotherapy resistance, it is likely that further work in this area will facilitate the development of new therapeutic approaches which will reach the clinic in the future.
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Affiliation(s)
| | - Dimitris Lagos
- Hull York Medical School, York, UK
- York Biomedical Research Institute, University of York, York, UK
| | - William J Brackenbury
- Department of Biology, University of York, York, UK.
- York Biomedical Research Institute, University of York, York, UK.
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22
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Association Between the Overall Risk of Prostate Cancer and Use of Calcium Channel Blockers: A Systematic Review and Meta-analysis. Clin Ther 2020; 42:1715-1727.e2. [PMID: 32807506 DOI: 10.1016/j.clinthera.2020.06.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/14/2020] [Accepted: 06/29/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Although calcium channel blockers (CCBs) are now commonly prescribed to treat hypertension as a first-line drug therapy, their impact on prostate cancer (PCa) is unclear. This systematic review and meta-analysis was conducted to determine the association between CCB use and the overall risk of PCa. METHODS PubMed, EMBASE, and Cochrane were searched up to December 26, 2019, stratified according to statistical method of outcome [odd ratios (ORs), relative ratios (RRs), hazard ratios (HRs)] and cumulative duration of CCB use. The quality assessment of included studies was evaluated by using the Newcastle-Ottawa Scale. Fixed effects models were used to study the association between CCB use and the risk of PCa. Between-study heterogeneity was quantified by using Cochran's Q-statistic and I2 statistics. Sensitivity analysis was performed by excluding the studies one by one, and publication bias was analyzed by using funnel plots. FINDINGS Nineteen studies with 1,418,407 patients were identified for inclusion in the meta-analysis, which was based on the comparison of cohort studies, nested case-control studies, and case-control studies. Pooled estimates showed a RR of 1.08 (95% CI, 1.05-1.11; P < 0.00001) and a HR of 1.07 (95% CI, 1.02-1.13; P = 0.008) for association between CCB use and the risk of PCa. In addition, the results of subgroup analysis showed that CCB users of <5 years had an 8% increased overall risk of PCa (RR, 1.08; 95% CI, 1.04-1.12; P = 0.0001), and CCB users of 5-10 years had a 13% increased overall risk of PCa (RR, 1.13; 95% CI, 1.04-1.23; P = 0.003). IMPLICATIONS CCB use had a tendency to increase the overall risk of PCa, and cumulative duration of CCB use might also be positively correlated with the overall risk of PCa.
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23
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Kumari N, Bhargava A, Rath SN. T-type calcium channel antagonist, TTA-A2 exhibits anti-cancer properties in 3D spheroids of A549, a lung adenocarcinoma cell line. Life Sci 2020; 260:118291. [PMID: 32810510 DOI: 10.1016/j.lfs.2020.118291] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 12/19/2022]
Abstract
AIMS Despite the advanced cancer treatments, there is increased resistance to chemotherapy and subsequent mortality. In lack of reliable data in monolayer cultures and animal models, researchers are shifting to 3D cancer spheroids, which represents the in vivo robust tumour morphology. Calcium is essential in cell signalling and proliferation. It is found that T-type calcium channels (TTCCs) are overexpressed in various cancer cells, supporting their increased proliferation. Many of the TTCCs blockers available could target other channels besides TTCCs, which can cause adverse effects. Therefore, we hypothesise that TTA-A2, a highly selective blocker towards TTCCs, can inhibit the growth of cancer spheroids, and provide an anti-cancer and an adjuvant role in cancer therapy. METHODS We studied TTA-A2 and paclitaxel (PTX-control drug) in lung adenocarcinoma cell line- A549, cancer cells and human embryonic kidney cell line- HEK 293, control cell, in their monolayer and spheroids forms for viability, proliferation, morphology change, migration, and invasion-after 48-96 h of treatment. KEY FINDINGS Though the results varied between the monolayer and spheroids studies, we found both anti-cancer as well as adjuvant effect of TTA-A2 in both the studies. TTA-A2 was able to inhibit the growth, viability, and metastasis of the cancer cells and spheroids. Differences in the results of two modes might explain that why drugs tested successfully in monolayer culture fail in clinical trials. SIGNIFICANCE This study establishes the role of TTA-A2, a potent TTCC blocker as an anti-cancer and adjuvant drug in reducing the viability and metastasis of the cancer cells.
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Affiliation(s)
- Neema Kumari
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Telangana, India; Department of Biotechnology, Indian Institute of Technology Hyderabad, Telangana, India
| | - Anamika Bhargava
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Telangana, India
| | - Subha Narayan Rath
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Telangana, India.
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24
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Raymakers A, Sin DD, Sadatsafavi M, FitzGerald JM, Marra CA, Lynd LD. Statin use and lung cancer risk in chronic obstructive pulmonary disease patients: a population-based cohort study. Respir Res 2020; 21:118. [PMID: 32429927 PMCID: PMC7236956 DOI: 10.1186/s12931-020-01344-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/26/2020] [Indexed: 01/03/2023] Open
Abstract
Background Patients living with chronic obstructive pulmonary disease (COPD) are at an increased risk of lung cancer. A common comorbidity of COPD is cardiovascular disease; as such, COPD patients often receive statins. This study sought to understand the association between statin exposure and lung cancer risk in a population-based cohort of COPD patients. Methods We identified a population-based cohort of COPD patients based on having filled at least three prescriptions for an anticholinergic or short-acting beta-agonist (SABA). We used an array of methods of defining medication exposure including three conventional methods (ever statin exposure, cumulative duration of use, and cumulative dose) and two novel methods (recency-weighted cumulative duration of use and recency-weighted cumulative dose). To assess residual confounding, a negative control exposure was used to test the validity of our results. All exposure variables were time-dependent. Results The population-based cohort of COPD had 39,879 patients with mean age of 70.6 (SD: 11.2) years and, of which, 53.5% were female. There were 12,469 patients who received at least one statin prescription. Results from the reference case multivariable analysis indicated a reduced risk from statin exposure (HR: 0.85 (95% CI: 0.73–1.00) in COPD patients, but this result not statistically significant. Using the two recency-weighted modelling approaches, statin exposure was associated with a statistically significant reduction in lung cancer risk (recency-weighted cumulative dose, HR: 0.85 (95% CI: 0.77–0.93) and recency-weighted cumulative duration of use, HR: 0.97 (95% CI: 0.96–0.99). Multivariable analysis incorporating the negative control exposure was not statistically significant (HR: 0.89 (95% CI: 0.75–1.10). Conclusions The results of this population-based analysis indicate that statin use in COPD patients may reduce the risk of lung cancer. While the effect was not statistically significantly across all exposure definitions, the overall results support the hypothesis that COPD patients might benefit from statin therapy.
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Affiliation(s)
- Ajn Raymakers
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia, V6T1Z3, Canada.,BC Cancer, Vancouver, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - D D Sin
- Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, Canada.,Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - M Sadatsafavi
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia, V6T1Z3, Canada
| | - J M FitzGerald
- Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - C A Marra
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - L D Lynd
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia, V6T1Z3, Canada. .,Centre for Health Evaluation and Outcome Sciences, Providence Health Research Institute, Vancouver, Canada.
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25
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Wong BS, Chiu LY, Tu DG, Sheu GT, Chan TT. Anticancer Effects of Antihypertensive L-Type Calcium Channel Blockers on Chemoresistant Lung Cancer Cells via Autophagy and Apoptosis. Cancer Manag Res 2020; 12:1913-1927. [PMID: 32214849 PMCID: PMC7078713 DOI: 10.2147/cmar.s228718] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/13/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose Hypertension and cancer are frequently found comorbidity occurring in same individual. This study was intended to evaluate the anticancer effects of commonly used antihypertensive medications and chemotherapy on chemoresistant lung cancer cells. Methods Calcium channel blockers (CCBs), including Verapamil, Diltiazem, and Nifedipine, either alone or combined with docetaxel (DOC) or vincristine (VCR) were used to treat A549 lung adenocarcinoma chemoresistant sublines. Cell viability was determined by MTT assay, and colony formation assay was used to demonstrate the long-term effect of CCBs on proliferation of the sublines. Apoptosis was evaluated by Annexin V assay and autophagy intensity was quantitated from acidic vesicular organelle formation. Pan-caspase inhibitor, shATG5 interference and chloroquine were applied to study the roles of Verapamil on apoptosis and autophagy, with related proteins verified by Western blot analysis. Results Results show that 10 μM of Verapamil and Diltiazem, but not Nifedipine, differentially induce autophagy in DOC-resistant or VCR-resistant A549 cells, respectively. When CCBs are combined with DOC or VCR to treat the sublines, 10 μM of Verapamil induces autophagy more significantly than Diltiazem and Nifedipine, respectively, in DOC-resistant (54.91±0.76, 18.03±0.69, 7.05±0.30) or VCR-resistant A549 (32.41±1.04, 21.51±0.63, 7.14±0.24) cells. Inhibition of apoptosis by pan-caspase inhibitor partly reduced cell death indicates association of caspase-dependent cell death but with persistence of autophagy. Inhibition of autophagy by interfering ATG5 expression reduced c-PARP level and apoptotic cells suggest a pro-death role of autophagy. Chloroquine treatment enhanced autophagosome accumulation and cell death but with reduced c-PARP level suggests that mechanism of caspase-independent cell death also contributes to Verapamil/chemotherapy-induced anticancer effects. Conclusion Verapamil combined with DOC or VCR induces chemoresistant lung cancer cells to death through autophagy burst and apoptosis more strongly than Diltiazem and Nifedipine. Administering Verapamil or Diltiazem individually with chemotherapy, but not Nifedipine, can be considered in lung cancer patients with hypertension.
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Affiliation(s)
- Bing-Sang Wong
- Division of Neurosurgery, Antai Medical Care Corporation Antai Tian-Sheng Memorial Hospital, Pingtung County, Taiwan
| | - Ling-Yen Chiu
- Department of Nuclear Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi City, Taiwan
| | - Dom-Gene Tu
- Department of Nuclear Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi City, Taiwan.,Department of Biomedical Sciences, National Chung Cheng University, Chiayi 62102, Taiwan
| | - Gwo-Tarng Sheu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Immunology Research Center, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ting-Tat Chan
- Palliative Care Unit, Department of Family Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi City, Taiwan
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26
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Shih JH, Kao LT, Chung CH, Liao GS, Fann LY, Chien WC, Li IH. Protective Association Between Calcium Channel Blocker Use and Breast Cancer Recurrence in Postsurgical Women: A Population-Based Case-Control Study in Taiwan. J Clin Pharmacol 2020; 60:785-792. [PMID: 32020656 DOI: 10.1002/jcph.1579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 12/18/2019] [Indexed: 12/14/2022]
Abstract
Neoadjuvant chemotherapy induces metastasis of residual breast cancers through activation of tumor-associated macrophages. Previous studies have indicated that calcium channel blockers (CCBs) exert anti-inflammatory and antimigratory effects on macrophages via attenuating Ca2+ entry into macrophages. However, no existing empirical research has addressed the relationship between previous CCB use and breast cancer recurrence. In this study, 4840 Taiwanese women aged ≥20 years with breast cancer who underwent breast surgery from January 1, 2007, to December 31, 2015, were enrolled. The date of cancer recurrence was defined as the index date. Logistic regression was performed to evaluate the relationship between previous CCB exposure and cancer recurrence among female patients who underwent surgery for breast cancer. After adjusting for demographic characteristics, comorbidities, and tumor-node-metastasis stage, the adjusted odds ratio (OR) for CCB exposure within 5 years before the index date in women with recurrence compared with nonrecurrent controls was 0.73 (95% confidence interval [CI], 0.53-0.97). Further analysis revealed that the adjusted OR for CCB exposure between the surgery and index dates in women with recurrence relative to nonrecurrent controls was 0.72 (95%CI, 0.66-0.95). In particular, prior CCB use was significantly associated with a lower risk (34%) of breast cancer recurrence among women 20 to 54 years old (OR, 0.66; 95%CI, 0.47-0.83). This study uncovered a protective association between previous CCB use and breast cancer recurrence.
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Affiliation(s)
- Jui-Hu Shih
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan.,School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
| | - Li-Ting Kao
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan.,School of Pharmacy, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Guo-Shiou Liao
- General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Li-Yun Fann
- Operating Room, Taipei City Hospital, Taipei, Taiwan
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - I-Hsun Li
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan.,School of Pharmacy, National Defense Medical Center, Taipei, Taiwan.,Department of Pharmacology, National Defense Medical Center, Taipei, Taiwan
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27
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Kanwar N, Carmine-Simmen K, Nair R, Wang C, Moghadas-Jafari S, Blaser H, Tran-Thanh D, Wang D, Wang P, Wang J, Pasculescu A, Datti A, Mak T, Lewis JD, Done SJ. Amplification of a calcium channel subunit CACNG4 increases breast cancer metastasis. EBioMedicine 2020; 52:102646. [PMID: 32062352 PMCID: PMC7016384 DOI: 10.1016/j.ebiom.2020.102646] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/20/2019] [Accepted: 01/15/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Previously, we found that amplification of chromosome 17q24.1-24.2 is associated with lymph node metastasis, tumour size, and lymphovascular invasion in invasive ductal carcinoma. A gene within this amplicon, CACNG4, an L-type voltage-gated calcium channel gamma subunit, is elevated in breast cancers with poor prognosis. Calcium homeostasis is achieved by maintaining low intracellular calcium levels. Altering calcium influx/efflux mechanisms allows tumour cells to maintain homeostasis despite high serum calcium levels often associated with advanced cancer (hypercalcemia) and aberrant calcium signaling. METHODS In vitro 2-D and 3-D assays, and intracellular calcium influx assays were utilized to measure tumourigenic activity in response to altered CANCG4 levels and calcium channel blockers. A chick-CAM model and mouse model for metastasis confirmed these results in vivo. FINDINGS CACNG4 alters cell motility in vitro, induces malignant transformation in 3-dimensional culture, and increases lung-specific metastasis in vivo. CACNG4 functions by closing the channel pore, inhibiting calcium influx, and altering calcium signaling events involving key survival and metastatic pathway genes (AKT2, HDAC3, RASA1 and PKCζ). INTERPRETATION CACNG4 may promote homeostasis, thus increasing the survival and metastatic ability of tumour cells in breast cancer. Our findings suggest an underlying pathway for tumour growth and dissemination regulated by CACNG4 that is significant with respect to developing treatments that target these channels in tumours with aberrant calcium signaling. FUNDING Canadian Breast Cancer Foundation, Ontario; Canadian Institutes of Health Research.
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Affiliation(s)
- Nisha Kanwar
- The Campbell Family for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
| | | | - Ranju Nair
- The Campbell Family for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
| | - Chunjie Wang
- Department of Pathology and Laboratory Medicine, Saskatoon City Hospital, Saskatoon, SK S7K 0M7, Canada
| | - Soode Moghadas-Jafari
- The Campbell Family for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
| | - Heiko Blaser
- The Campbell Family for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
| | - Danh Tran-Thanh
- Department of Pathology, Centre Hospitalier de l'Université de Montréal, Montréal, QC H2W 1T8, Canada
| | - Dongyu Wang
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, ON M5S 1A1, Canada
| | - Peiqi Wang
- The Campbell Family for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
| | - Jenny Wang
- Samuel Lunenfeld Research Institute, Mt. Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Adrian Pasculescu
- Samuel Lunenfeld Research Institute, Mt. Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Alessandro Datti
- Samuel Lunenfeld Research Institute, Mt. Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Agricultural, Food, and Environmental Sciences, University of Perugia, Perugia, Italy
| | - Tak Mak
- The Campbell Family for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada; Department of Medical Biophysics, Faculty of Medicine, University of Toronto, ON M5S 1A1, Canada
| | - John D Lewis
- Department of Oncology, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Susan J Done
- The Campbell Family for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; Department of Medical Biophysics, Faculty of Medicine, University of Toronto, ON M5S 1A1, Canada; Laboratory Medicine Program, Department of Pathology, University Health Network, Toronto General Hospital, 200 Elizabeth Street, 11th floor, Toronto, ON M5G 2C4, Canada.
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28
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Siddiqi N, Shatat IF. Antihypertensive agents: a long way to safe drug prescribing in children. Pediatr Nephrol 2020; 35:2049-2065. [PMID: 31676933 PMCID: PMC7515858 DOI: 10.1007/s00467-019-04314-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/12/2019] [Accepted: 07/23/2019] [Indexed: 01/07/2023]
Abstract
Recently updated clinical guidelines have highlighted the gaps in our understanding and management of pediatric hypertension. With increased recognition and diagnosis of pediatric hypertension, the use of antihypertensive agents is also likely to increase. Drug selection to treat hypertension in the pediatric patient population remains challenging. This is primarily due to a lack of large, well-designed pediatric safety and efficacy trials, limited understanding of pharmacokinetics in children, and unknown risk of prolonged exposure to antihypertensive therapies. With newer legislation providing financial incentives for conducting clinical trials in children, along with publication of pediatric-focused guidelines, literature available for antihypertensive agents in pediatrics has increased over the last 20 years. The objective of this article is to review the literature for safety and efficacy of commonly prescribed antihypertensive agents in pediatrics. Thus far, the most data to support use in children was found for angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), and calcium channel blockers (CCB). Several gaps were noted in the literature, particularly for beta blockers, vasodilators, and the long-term safety profile of antihypertensive agents in children. Further clinical trials are needed to guide safe and effective prescribing in the pediatric population.
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Affiliation(s)
- Nida Siddiqi
- Department of Pharmacy, Sidra Medicine, Doha, Qatar
| | - Ibrahim F. Shatat
- Pediatric Nephrology and Hypertension, Sidra Medicine, HB. 7A. 106A, PO Box 26999, Doha, Qatar ,Weill Cornell College of Medicine-Qatar, Ar-Rayyan, Qatar ,grid.259828.c0000 0001 2189 3475Medical University of South Carolina, Charleston, SC USA
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29
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Kao LT, Huang CC, Lin HC, Huang CY. Antiarrhythmic drug usage and prostate cancer: a population-based cohort study. Asian J Androl 2019; 20:37-42. [PMID: 28857052 PMCID: PMC5753552 DOI: 10.4103/aja.aja_26_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Even though the relationship between antiarrhythmic drug usage and subsequent prostate cancer (PCa) risk has recently been highlighted, relevant findings in the previous literature are still inconsistent. In addition, very few studies have attempted to investigate the association between sodium channel blockers or potassium channel blockers for arrhythmia and the subsequent PCa risk. Therefore, this cohort study aimed to find the relationship between antiarrhythmic drug usage and the subsequent PCa risk using a population-based dataset. The data used in this study were derived from the Longitudinal Health Insurance Database 2005, Taiwan, China. We respectively identified 9988 sodium channel blocker users, 3663 potassium channel blocker users, 65 966 beta-blocker users, 23 366 calcium channel blockers users, and 7031 digoxin users as the study cohorts. The matched comparison cohorts (one comparison subject for each antiarrhythmic drug user) were selected from the same dataset. Each patient was tracked for a 5-year period to define those who were subsequently diagnosed with PCa. After adjusting for sociodemographic characteristics, comorbidities, and age, Cox proportional hazard regressions found that the hazard ratio (HR) of subsequent PCa for sodium channel blocker users was 1.12 (95% confidence interval [CI]: 0.84–1.50), for potassium channel blocker users was 0.89 (95% CI: 0.59–1.34), for beta-blocker users was 1.08 (95% CI: 0.96–1.22), for calcium channel blocker users was 1.14 (95% CI: 0.95–1.36), and for digoxin users was 0.89 (95% CI: 0.67–1.18), compared to their matched nonusers. We concluded that there were no statistical associations between different types of antiarrhythmic drug usage and subsequent PCa risk.
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Affiliation(s)
- Li-Ting Kao
- Graduate Institute of Life Science, National Defense Medical Center, Taipei 110, Taiwan, China.,Sleep Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan, China
| | - Chung-Chien Huang
- School of Health Care Administration, Taipei Medical University, Taipei 110, Taiwan, China
| | - Herng-Ching Lin
- Sleep Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan, China.,School of Health Care Administration, Taipei Medical University, Taipei 110, Taiwan, China
| | - Chao-Yuan Huang
- Department of Urology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 110, Taiwan, China.,Department of Urology, National Taiwan University Hospital, Hsin Chu Branch, Hsin Chu City 100, Taiwan, China.,School of Public Health, Taipei Medical University, Taipei 100, Taiwan, China
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30
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Meijers WC, de Boer RA. Common risk factors for heart failure and cancer. Cardiovasc Res 2019; 115:844-853. [PMID: 30715247 PMCID: PMC6452432 DOI: 10.1093/cvr/cvz035] [Citation(s) in RCA: 175] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/29/2019] [Accepted: 02/01/2019] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular (CV) disease and cancer are the leading causes of death.1,2 Over the last decades, it has been appreciated that both CV disease and cancer are more common in individuals in whom risk factors for disease development accumulate, and preventative measures have been extremely important in driving down the incidence of disease.3-6 In general, the field of epidemiology, risk reduction, and preventative trials is divided into health care professionals who have an interest in either CV disease or cancer. As a result, the medical literature and medical practice has largely focused on the one disease, or the other. However, human individuals do not behave according to this dogma. Emerging data clearly suggest that identical risk factors may lead to CV disease in the one individual, but may cause cancer in another, or even both diseases in the same individual. This overlap exists between risk factors that are historically classified as 'CV risk factors' as these factors do equally strong predict cancer development. Therefore, we propose that a holistic approach might better estimate actual risks for CV disease and cancer. In this review, we summarize current insights in common behavioural risk factors for heart failure, being the most progressed and lethal form of CV disease, and cancer.
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Affiliation(s)
- Wouter C Meijers
- University Medical Centre Groningen, University of Groningen, Department of Cardiology, Hanzeplein 1, Groningen, The Netherlands
| | - Rudolf A de Boer
- University Medical Centre Groningen, University of Groningen, Department of Cardiology, Hanzeplein 1, Groningen, The Netherlands
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Burnier M, Narkiewicz K, Kjeldsen SE, Oparil S. New data on antihypertensive drugs and risk of cancer: should we worry? Blood Press 2019; 28:1-3. [PMID: 30714837 DOI: 10.1080/08037051.2019.1568182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Michel Burnier
- a Service of Nephrology and Hypertension , Centre Hospitalier Universitaire Vaudois , Lausanne , Switzerland
| | - Krzysztof Narkiewicz
- b Department of Hypertension and Diabetology , Medical University of Gdansk , Poland
| | - Sverre E Kjeldsen
- c Department of Cardiology , University of Oslo, Ullevaal Hospital , Oslo , Norway
| | - Suzanne Oparil
- d Vascular Biology and Hypertension Program, Department of Medicine , University of Alabama at Birmingham , AL , USA
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郭 睿, 金 雪, 田 怡, 黄 小, 李 宗, 杨 军. [Calcium channel blocker diltizem transiently inhibits migration and up-regulates metadherin expression in hepatocellular carcinoma cells in vitro]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:298-303. [PMID: 31068314 PMCID: PMC6765685 DOI: 10.12122/j.issn.1673-4254.2019.03.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the effect of calcium channel blocker diltizem in reversing multi-drug resistance (MDR) and on metadherin expression in hepatocellular carcinoma cells and explore the molecular mechanism. METHODS Hepatocellular carcinoma MHCC97H and 7402 cells were treated with diltiazem hydrochloride, a calcium channel blocker (0, 25, 50, 100, 200, and 400 μmol/L), for 12, 24, or 48 h. Wound healing assay was employed to assess the changes in the mobility and migration of the cells following the treatments, and the changes in the expression levels of metadherin mRNA and protein and P-gp protein were determined using RT-PCR and immunocytochemistry. RESULTS Diltiazem hydrochloride could transiently inhibit the migration and movement of MHCC97H and 7402 cells in vitro in a time-and concentration-dependent manner (P < 0.05). Diltiazem hydrochloride at different concentrations also transiently up-regulated the expressions of metadherin mRNA and protein but did not inhibit the expression of P-gp protein in MHCC97H and 7402 cells. CONCLUSIONS Calcium channel blocker can transiently inhibit the migration of hepatocellular carcinoma cells in vitro and up-regulate the expression of metadherin mRNA and protein through a feedback mechanism, suggesting the potential risk of calcium channel blockers for promoting tumor progression during the treatment of malignant tumors.
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Affiliation(s)
- 睿 郭
- 西安交通大学第二附属医院病理科, 陕西 西安 710004Department of Pathology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - 雪媛 金
- 西安交通大学第二附属医院病理科, 陕西 西安 710004Department of Pathology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - 怡 田
- 西安交通大学第二附属医院病理科, 陕西 西安 710004Department of Pathology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - 小钟 黄
- 西安交通大学第二附属医院病理科, 陕西 西安 710004Department of Pathology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - 宗芳 李
- 生物诊断治疗国家地方联合工程研究中心, 陕西 西安 710004National & Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Xi'an 710004, China
| | - 军 杨
- 西安交通大学第二附属医院病理科, 陕西 西安 710004Department of Pathology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
- 生物诊断治疗国家地方联合工程研究中心, 陕西 西安 710004National & Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Xi'an 710004, China
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Rotshild V, Azoulay L, Feldhamer I, Perlman A, Muszkat M, Matok I. Calcium Channel Blocker Use and the Risk for Prostate Cancer: A Population-Based Nested Case-Control Study. Pharmacotherapy 2019; 39:690-696. [PMID: 30917404 DOI: 10.1002/phar.2266] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Calcium channels play a significant role in the regulation of cell proliferation and apoptosis. This study investigates associations between calcium channel blocker (CCB) use and the incidence of prostate cancer (PCa). METHODS A nested case-control study was conducted using the Clalit Health Services database. We formed a population-based cohort of patients who were prescribed their first antihypertensive agent between 2000 and 2014. For each newly diagnosed PCa case in the cohort, 10 controls were matched by age, calendar year of cohort entry, and duration of follow-up. Multivariate conditional logistic regression analyses were used to evaluate the odds ratios (ORs) of PCa among CCB users compared with users of other antihypertensive drugs. RESULTS We identified 4346 patients with newly diagnosed PCa during the median follow-up of 5.3 years. The exposure to CCBs was associated with a slight increase in risk for PCa (OR 1.10, 95% confidence interval [CI] 1.02-1.18) when compared with non-CCB antihypertensive drugs. In secondary analyses, evidence was found of a duration-response relationship, with the association for PCa increasing by 27% for every 10-year increment of CCB use (OR 1.27, 95% CI 1.04-1.56). CONCLUSIONS The results of this large population-based study indicate a modest but significant increase in the risk of PCa among CCB users, and the risk increases with duration of use.
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Affiliation(s)
- Victoria Rotshild
- Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy and The David R. Bloom Center of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Laurent Azoulay
- Department of Epidemiology, Biostatistics, and Occupational Health, and Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.,Centre for Clinical Epidemiology, Oncology Department, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ilan Feldhamer
- Research and Information Department, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel
| | - Amichai Perlman
- Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy and The David R. Bloom Center of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mordechai Muszkat
- Department of Internal Medicine, Hadassah University Hospital Mt. Scopus, Jerusalem, Israel
| | - Ilan Matok
- Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy and The David R. Bloom Center of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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34
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Intriguing relationship between antihypertensive therapy and cancer. Pharmacol Res 2019; 141:501-511. [DOI: 10.1016/j.phrs.2019.01.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022]
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Siltari A, Murtola TJ, Talala K, Taari K, Tammela TLJ, Auvinen A. Antihypertensive drugs and prostate cancer risk in a Finnish population-based cohort. Scand J Urol 2019; 52:321-327. [PMID: 30698056 DOI: 10.1080/21681805.2018.1559882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The etiology of prostate cancer (PCa) involves environmental and genetic factors. Understanding the role of medication use on PCa risk may clarify the pathophysiological changes and mechanisms in development of cancer. METHODS This study investigated PCa risk in relation to overall use of anti-hypertensive drugs and those with specific mechanisms of action. The study cohort (78,615 men) was linked to the prescription database to obtain information on medication use during 20-year follow-up. Information was obtained on PCa diagnoses, causes of deaths, and for a sub-set on B.M.I. and use of non-prescription drugs. Time-dependent drug use variables hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression analyses. RESULTS Use of antihypertensive drugs slightly increased PCa risk (HR = 1.16, 95% CI = 1.11-1.22). The risk increase was clearest for metastatic PCa (HR = 1.36, 95% CI = 1.14-1.62). ACE inhibitors, beta-blockers, and diuretics were all separately associated with a small excess risk (HR = 1.10, 95% CI = 1.01-1.19, HR = 1.14, 95% CI = 1.06-1.21, and HR = 1.16, 95% CI = 1.07-1.27, respectively). None of the other groups showed a clear association with PCa risk. CONCLUSIONS The use of antihypertensive drugs was associated with increased prostate cancer risk. Similar risk association for multiple drug groups suggests that the findings may not reflect a direct medication effect, but may be due to underlying hypertension.
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Affiliation(s)
- Aino Siltari
- a Faculty of Medicine, Pharmacology , University of Helsinki , Helsinki , Finland.,b Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland
| | - Teemu J Murtola
- b Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,c Department of Urology , Tampere University Hospital , Tampere , Finland.,d Department of Surgery , Seinäjoki Central Hospital , Seinäjoki , Finland
| | | | - Kimmo Taari
- f Department of Urology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Teuvo L J Tammela
- b Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,c Department of Urology , Tampere University Hospital , Tampere , Finland
| | - Anssi Auvinen
- g Faculty of Social Sciences , University of Tampere , Tampere , Finland
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Thakur AA, Wang X, Garcia-Betancourt MM, Forse RA. Calcium channel blockers and the incidence of breast and prostate cancer: A meta-analysis. J Clin Pharm Ther 2018; 43:519-529. [DOI: 10.1111/jcpt.12673] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 02/01/2018] [Indexed: 01/07/2023]
Affiliation(s)
- A. A. Thakur
- Internal Medicine; Danbury Hospital; Western Connecticut Health Network; Danbury CT USA
- Doctor's Hospital at Renaissance Health System; Edinburg TX USA
| | - X. Wang
- Department of Mathematics and Statistics; University of Texas-Rio Grande Valley; Edinburg TX USA
| | - M. M. Garcia-Betancourt
- Department of Academic Medicine; Doctors Hospital at Renaissance Health System; Edinburg TX USA
| | - R. A. Forse
- Doctor's Hospital at Renaissance Health System; Edinburg TX USA
- Doctor’s Hospital at Renaissance Health System Clinical Professor of Surgery; University of Texas-Rio Grande Valley; Edinburg TX USA
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Chen GH, Li YC, Lin NH, Kuo PC, Tzen JTC. Characterization of Vasorelaxant Principles from the Needles of Pinus morrisonicola Hayata. Molecules 2017; 23:molecules23010086. [PMID: 29301239 PMCID: PMC6017640 DOI: 10.3390/molecules23010086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 12/29/2017] [Accepted: 12/30/2017] [Indexed: 12/18/2022] Open
Abstract
Pinus morrisonicola Hayata, usually called Taiwan five-leaf pine (5LP), is an endemic species in Taiwan and is traditionally used to relieve hypertension symptoms and improve cardiovascular function. In this study, the needle extract of 5LP was fractionated and analyzed by LC/MS/MS to search for possible antihypertensive candidates. In addition, bioassay-guided purification of the bioactive components was performed by Ca2+ fluorescent signal (Fluo 4-AM) assays. Two dihydrobenzofuran lignans, pinumorrisonide A (1) and icariside E4 (2), and one acylated flavonoid glycoside, kaempferol 3-O-α-(6‴-p-coumaroylglucosyl-β-1,4-rhamnoside) (3) were characterized from the active fractions. The structure of a new compound 1 was established on the basis of 2D NMR spectroscopic and mass spectrometric analyses, and the known compounds 2 and 3 were identified by comparison of their physical and spectroscopic data with those reported in the literature. The purified compounds 1–3 exhibited significant inhibition of Ca2+ fluorescence with IC50 values of 0.71, 0.36, and 0.20 mM, respectively. A mechanism study showed that these compounds showed vasorelaxant effects by blocking the voltage-operated Ca2+ channel (VOCC) and inhibiting Ca2+ influx to the cytoplasmic. These results suggested that 5LP and the three characterized components could be promising antihypertensive candidates for the use as VOCC blockers.
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Affiliation(s)
- Guan-Heng Chen
- Graduate Institute of Biotechnology, National Chung-Hsing University, Taichung 402, Taiwan.
| | - Yue-Chiun Li
- Graduate Institute of Biotechnology, National Chung-Hsing University, Taichung 402, Taiwan.
| | - Nan-Hei Lin
- Graduate Institute of Biotechnology, National Chung-Hsing University, Taichung 402, Taiwan.
| | - Ping-Chung Kuo
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
| | - Jason T C Tzen
- Graduate Institute of Biotechnology, National Chung-Hsing University, Taichung 402, Taiwan.
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Wright CM, Moorin RE, Chowdhury EK, Stricker BH, Reid CM, Saunders CM, Hughes JD. Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence. Cancer Epidemiol 2017; 50:113-124. [PMID: 28866282 DOI: 10.1016/j.canep.2017.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/15/2017] [Accepted: 08/19/2017] [Indexed: 12/18/2022]
Abstract
Controversy exists regarding the potential association between taking calcium channel blockers (CCBs) and the development of breast cancer. As a positive association would have important public health implications due to the widespread use of CCBs, this study aimed to incorporate new evidence to determine whether an association is likely to exist. We searched MEDLINE, EMBASE and the Cochrane Library to 28 June 2016 for relevant literature. References and citing articles were checked and authors contacted as necessary. Two authors independently selected articles and extracted data. Twenty-nine studies were reviewed; 26 were non-randomised studies (NRS). Meta-analysis of study data where adjustment for 'confounding by indication' was judged to be present suggests that an association, if any, is likely to be modest in magnitude (pooled odds/risk ratio 1.09 (95% confidence interval (CI) 1.03-1.15, I2=0%, 8 sub-studies; pooled hazard ratio 0.99 (95% CI 0.94-1.03, I2=35%, 9 sub-studies)). There are credible study data showing an increased relative risk with long-term use of CCBs, but the results of our meta-analysis and of meta-regression of log relative risk against minimum follow-up time are mixed. The current summative evidence does not support a clear association between taking CCBs and developing breast cancer. However, uncertainty remains, especially for long-term use and any association might not be uniform between different populations and/or breast cancer sub-types. We thus recommend further NRS in settings where CCB use is highly prevalent and population-based cancer, prescription and health-registries exist, to resolve this continuing uncertainty. PROSPERO, CRD42015026712.
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Affiliation(s)
- Cameron M Wright
- Health Systems and Health Economics, School of Public Health, Faculty of Health Sciences, GPO Box U1987, Curtin University, Perth, Western Australia, 6845, Australia; School of Pharmacy, Faculty of Health Sciences, GPO Box U1987, Curtin University, Perth, Western Australia, 6845, Australia; School of Medicine, University of Tasmania, Private Bag 26, Sandy Bay, Tasmania, 7001, Australia.
| | - Rachael E Moorin
- Health Systems and Health Economics, School of Public Health, Faculty of Health Sciences, GPO Box U1987, Curtin University, Perth, Western Australia, 6845, Australia; Centre for Health Services Research, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, 35 Stirling Highway, University of Western Australia, Crawley, Perth, Western Australia, 6009, Australia.
| | - Enayet K Chowdhury
- Centre for Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, 3800, Australia.
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus MC: University Medical Centre, Rotterdam, 3015, Netherlands.
| | - Christopher M Reid
- School of Pharmacy, Faculty of Health Sciences, GPO Box U1987, Curtin University, Perth, Western Australia, 6845, Australia; School of Public Health, Faculty of Health Sciences, GPO Box 1987, Curtin University, Perth, Western Australia, 6845, Australia.
| | - Christobel M Saunders
- School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, 35 Stirling Highway, University of Western Australia, Perth, Western Australia, 6009, Australia.
| | - Jeffery D Hughes
- School of Pharmacy, Faculty of Health Sciences, GPO Box U1987, Curtin University, Perth, Western Australia, 6845, Australia.
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Brasky TM, Krok-Schoen JL, Liu J, Chlebowski RT, Freudenheim JL, Lavasani S, Margolis KL, Qi L, Reding KW, Shields PG, Simon MS, Wactawski-Wende J, Wang A, Womack C, Manson JE. Use of Calcium Channel Blockers and Breast Cancer Risk in the Women's Health Initiative. Cancer Epidemiol Biomarkers Prev 2017; 26:1345-1348. [PMID: 28765339 PMCID: PMC5607775 DOI: 10.1158/1055-9965.epi-17-0096] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 02/17/2017] [Accepted: 04/13/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Use of calcium channel blockers (CCBs) has been associated with increased risk of breast cancer in some, but not all, studies. Differences in reported associations from prior studies may be due, in part, to inadequate control of confounding factors.Methods: Participants were 28,561 postmenopausal women from the Women's Health Initiative who reported use of either CCBs or other antihypertensive medications (AHMs) at baseline; 1,402 incident breast cancer cases were diagnosed during 12 years of follow-up. Adjusted Cox regression models were used to estimate HRs and 95% confidence intervals (CI) for the associations between CCB use relative to other AHM use and breast cancer risk.Results: Use of CCBs was not associated with breast cancer risk (HR, 1.06; 95% CI, 0.94-1.20) relative to use of other AHMs. Associations approximated the null value when CCBs were considered by duration of use, length of action, or drug class.Conclusions: We provide additional evidence that CCBs do not influence breast cancer risk in postmenopausal women.Impact: The results from this study, which includes strong control for potential confounding factors, cast doubt on increases in risk with CCBs. Cancer Epidemiol Biomarkers Prev; 26(8); 1345-8. ©2017 AACR.
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Affiliation(s)
- Theodore M Brasky
- Division of Cancer Prevention and Control, The Ohio State University College of Medicine, Columbus, Ohio.
| | - Jessica L Krok-Schoen
- Division of Cancer Prevention and Control, The Ohio State University College of Medicine, Columbus, Ohio
- Division of Medical Dietetics and Health Sciences, The Ohio State University College of Medicine, Columbus, Ohio
| | - Jingmin Liu
- WHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Rowan T Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
| | | | | | - Lihong Qi
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California-Davis, Davis, California
| | - Kerryn W Reding
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington
| | - Peter G Shields
- Division of Cancer Prevention and Control, The Ohio State University College of Medicine, Columbus, Ohio
| | - Michael S Simon
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
| | - Ange Wang
- Stanford University School of Medicine, Stanford University, Stanford, California
| | - Catherine Womack
- Departments of Preventive Medicine and Internal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Kurz X. Advancing regulatory science, advancing regulatory practice. Pharmacoepidemiol Drug Saf 2017; 26:722-726. [PMID: 28220974 PMCID: PMC5484349 DOI: 10.1002/pds.4181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/29/2016] [Accepted: 01/19/2017] [Indexed: 11/21/2022]
Affiliation(s)
- Xavier Kurz
- European Medicines Agency, Department Pharmacovigilance and Epidemiology, London, UK
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Geybels MS, McCloskey KD, Mills IG, Stanford JL. Calcium Channel Blocker Use and Risk of Prostate Cancer by TMPRSS2:ERG Gene Fusion Status. Prostate 2017; 77:282-290. [PMID: 27753122 PMCID: PMC5668682 DOI: 10.1002/pros.23267] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/30/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Calcium channel blockers (CCBs) may affect prostate cancer (PCa) growth by various mechanisms including those related to androgens. The fusion of the androgen-regulated gene TMPRSS2 and the oncogene ERG (TMPRSS2:ERG or T2E) is common in PCa, and prostate tumors that harbor the gene fusion are believed to represent a distinct disease subtype. We studied the association of CCB use with the risk of PCa, and molecular subtypes of PCa defined by T2E status. METHODS Participants were residents of King County, Washington, recruited for population-based case-control studies (1993-1996 or 2002-2005). Tumor T2E status was determined by fluorescence in situ hybridization using tumor tissue specimens from radical prostatectomy. Detailed information on use of CCBs and other variables was obtained through in-person interviews. Binomial and polytomous logistic regression were used to generate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The study included 1,747 PCa patients and 1,635 age-matched controls. A subset of 563 patients treated with radical prostatectomy had T2E status determined, of which 295 were T2E positive (52%). Use of CCBs (ever vs. never) was not associated with overall PCa risk. However, among European-American men, users had a reduced risk of higher-grade PCa (Gleason scores ≥7: adjusted OR = 0.64; 95% CI: 0.44-0.95). Further, use of CCBs was associated with a reduced risk of T2E positive PCa (adjusted OR = 0.38; 95% CI: 0.19-0.78), but was not associated with T2E negative PCa. CONCLUSIONS This study found suggestive evidence that use of CCBs is associated with reduced relative risks for higher Gleason score and T2E positive PCa. Future studies of PCa etiology should consider etiologic heterogeneity as PCa subtypes may develop through different causal pathways. Prostate 77:282-290, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Milan S. Geybels
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
- Corresponding authors: ;
| | - Karen D. McCloskey
- Centre for Cancer Research and Cell Biology, Queen’s University of Belfast, Belfast, UK
| | - Ian G. Mills
- Prostate Cancer Research Group, Centre for Molecular Medicine, University of Oslo and Oslo University Hospitals, Oslo, Norway; Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospitals-Radium Hospital, Montebello, Oslo, Norway
| | - Janet L. Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Epidemiology, University of Washington, School of Public Health, Seattle, Washington
- Corresponding authors: ;
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Klungel OH, Kurz X, de Groot MCH, Schlienger RG, Tcherny-Lessenot S, Grimaldi L, Ibáñez L, Groenwold RHH, Reynolds RF. Multi-centre, multi-database studies with common protocols: lessons learnt from the IMI PROTECT project. Pharmacoepidemiol Drug Saf 2017; 25 Suppl 1:156-65. [PMID: 27038361 DOI: 10.1002/pds.3968] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 12/09/2015] [Accepted: 12/11/2015] [Indexed: 12/17/2022]
Abstract
PURPOSE To assess the impact of a variety of methodological parameters on the association between six drug classes and five key adverse events in multiple databases. METHODS The selection of Drug-Adverse Event pairs was based on public health impact, regulatory relevance, and the possibility to study a broad range of methodological issues. Common protocols and data analytical specifications were jointly developed and independently and blindly executed in different databases in Europe with replications in the same and different databases. RESULTS The association between antibiotics and acute liver injury, benzodiazepines and hip fracture, antidepressants and hip fracture, inhaled long-acting beta2-agonists and acute myocardial infarction was consistent in direction across multiple designs, databases and methods to control for confounding. Some variation in magnitude of the associations was observed depending on design, exposure and outcome definitions, but none of the differences were statistically significant. The association between anti-epileptics and suicidality was inconsistent across the UK CPRD, Danish National registries and the French PGRx system. Calcium channel blockers were not associated with the risk of cancer in the UK CPRD, and this was consistent across different classes of calcium channel blockers, cumulative durations of use up to >10 years and different types of cancer. CONCLUSIONS A network for observational drug effect studies allowing the execution of common protocols in multiple databases was created. Increased consistency of findings across multiple designs and databases in different countries will increase confidence in findings from observational drug research and benefit/risk assessment of medicines.
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Affiliation(s)
- Olaf H Klungel
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
| | - Xavier Kurz
- European Medicines Agency (EMA), London, United Kingdom
| | - Mark C H de Groot
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.,Department of Clinical Chemistry and Haematology, Division of Laboratory and Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | | | - Lamiae Grimaldi
- LA-SER and Pasteur Institute (Pharmacoepidemiology and Infectious Diseases Unit), Paris, France
| | - Luisa Ibáñez
- Fundació Institut Català de Farmacologia (FICF), Barcelona, Spain
| | - Rolf H H Groenwold
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
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van der Laan JW, Buitenhuis WHW, Wagenaar L, Soffers AEMF, van Someren EP, Krul CAM, Woutersen RA. Prediction of the Carcinogenic Potential of Human Pharmaceuticals Using Repeated Dose Toxicity Data and Their Pharmacological Properties. Front Med (Lausanne) 2016; 3:45. [PMID: 27790617 PMCID: PMC5063850 DOI: 10.3389/fmed.2016.00045] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/20/2016] [Indexed: 01/06/2023] Open
Abstract
In an exercise designed to reduce animal use, we analyzed the results of rat subchronic toxicity studies from 289 pharmaceutical compounds with the aim to predict the tumor outcome of carcinogenicity studies in this species. The results were obtained from the assessment reports available at the Medicines Evaluation Board of the Netherlands for 289 pharmaceutical compounds that had been shown to be non-genotoxic. One hundred forty-three of the 239 compounds not inducing putative preneoplastic lesions in the subchronic study did not induce tumors in the carcinogenicity study [true negatives (TNs)], whereas 96 compounds were categorized as false negatives (FNs) because tumors were observed in the carcinogenicity study. Of the remaining 50 compounds, 31 showed preneoplastic lesions in the subchronic study and tumors in the carcinogenicity study [true positives (TPs)], and 19 only showed preneoplastic lesions in subchronic studies but no tumors in the carcinogenicity study [false positives (FPs)]. In addition, we then re-assessed the prediction of the tumor outcome by integrating the pharmacological properties of these compounds. These pharmacological properties were evaluated with respect to the presence or absence of a direct or indirect proliferative action. We found support for the absence of cellular proliferation for 204 compounds (TN). For 67 compounds, the presence of cellular hyperplasia as evidence for proliferative action could be found (TP). Therefore, this approach resulted in an ability to predict non-carcinogens at a success rate of 92% and the ability to detect carcinogens at 98%. The combined evaluation of pharmacological and histopathological endpoints eventually led to only 18 unknown outcomes (17 categorized as FN and 1 as FP), thereby enhancing both the negative and positive predictivity of an evaluation based upon histopathological evaluation only. The data show the added value of a consideration of the pharmacological properties of compounds in relation to potential class effects, both in the negative and positive direction. A high negative and a high positive predictivity will both result in waiving the need for conducting 2-year rat carcinogenicity studies, if this is accepted by Regulatory Authorities, which will save large numbers of animals and reduce drug development costs and time.
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Affiliation(s)
- Jan Willem van der Laan
- Medicines Evaluation Board, Utrecht, Netherlands
- Division of Toxicology, Leiden Academic Center for Drug Research, Leiden, Netherlands
| | | | | | - Ans E. M. F. Soffers
- Division of Toxicology, Wageningen University and Research Centre, Wageningen, Netherlands
| | | | | | - Ruud A. Woutersen
- Division of Toxicology, Wageningen University and Research Centre, Wageningen, Netherlands
- TNO Innovation for Life, Zeist, Netherlands
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van der Laan JW, Kasper P, Silva Lima B, Jones DR, Pasanen M. Critical analysis of carcinogenicity study outcomes. Relationship with pharmacological properties. Crit Rev Toxicol 2016; 46:587-614. [DOI: 10.3109/10408444.2016.1163664] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | - Peter Kasper
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | | | - David R. Jones
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Markku Pasanen
- Faculty of Health Sciences, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
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