| アブストラクト | PURPOSE: Evidence is insufficient to infer whether topical calcineurin inhibitors (TCIs; tacrolimus and pimecrolimus) cause malignancy. The study objective was to estimate the long-term risk of skin cancer and lymphoma associated with topical TCI use in adults and children, separately. PATIENTS AND METHODS: A cohort study in Denmark, Sweden, UK, and the Netherlands was conducted. Adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated for nonmelanoma skin cancer (NMSC), melanoma, cutaneous T-cell lymphoma (CTCL), non-Hodgkin lymphoma (NHL) excluding CTCL, and Hodgkin lymphoma (HL) in new users of TCIs versus users of moderate/high-potency topical corticosteroids. RESULTS: The study included 126,908/61,841 adults and 32,605/27,961 children initiating treatment with tacrolimus/pimecrolimus, respectively. Follow-up was >/=10 years for 19% of adults and 32% of children. Incidence rate ratios and (95% confidence intervals) for tacrolimus versus corticosteroid users in adults were <1 for melanoma, non-Hodgkin lymphoma, and Hodgkin lymphoma; and 1.80 (1.25-2.58) for cutaneous T-cell lymphoma. For pimecrolimus, IRRs in adults were <1 for non-Hodgkin lymphoma, cutaneous T-cell lymphoma, and Hodgkin's lymphoma; and 1.21 (1.03-1.41) for melanoma; and 1.28 (1.20-1.35) for nonmelanoma skin cancer. In children, results were inconclusive due to few events. In adults, incidence rate ratios >/=5 years after first topical calcineurin inhibitor exposure were not higher than in overall analyses. CONCLUSION: Overall, we found little evidence associating use of topical calcineurin inhibitors with skin cancer and lymphoma; confounding by indication, surveillance bias, and reverse causation may have influenced these results. Even if causal, the public health impact of these excess risks would be low and confined to the first years of exposure. |
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| ジャーナル名 | Clinical epidemiology |
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| Pubmed追加日 | 2022/1/11 |
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| 投稿者 | Arana, Alejandro; Pottegard, Anton; Kuiper, Josephina G; Booth, Helen; Reutfors, Johan; Calingaert, Brian; Lund, Lars Christian; Crellin, Elizabeth; Schmitt-Egenolf, Marcus; Kaye, James A; Gembert, Karin; Rothman, Kenneth J; Kieler, Helle; Dedman, Daniel; Houben, Eline; Gutierrez, Lia; Hallas, Jesper; Perez-Gutthann, Susana |
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| 組織名 | Department of Epidemiology, RTI Health Solutions, Barcelona, 08028, Spain.;Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public;Health, University of Southern Denmark, Odense C, 5000, Denmark.;The PHARMO Institute, Utrecht, 3528 AE, the Netherlands.;Clinical Practice Research Datalink (CPRD), The Medicines and Healthcare Products;Regulatory Agency, London, E14 4PU, UK.;Centre for Pharmacoepidemiology, Karolinska Institutet, Solna, 171 76, Stockholm,;Sweden.;Department of Epidemiology, RTI Health Solutions, Research Triangle Park, NC,;27709-2194, USA.;Department of Public Health and Clinical Medicine, Umea University, Umea, 901 87,;Department of Epidemiology, RTI Health Solutions, Waltham, MA, 02451-1623, USA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35002327/ |
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