| アブストラクト | INTRODUCTION: There are concerns that hydrochlorothiazide may increase the risk of incident nonmelanoma (cutaneous squamous cell carcinoma [cSCC], basal cell carcinoma [BCC]) and melanoma skin cancer, with regulatory agencies and societies calling for additional studies. METHODS: We conducted a propensity score-matched population-based cohort study using the United Kingdom Clinical Practice Research Datalink. A total of 20,513 new users of hydrochlorothiazide were propensity score matched, in a 1:1 ratio, to new users of other thiazide diuretics between January 1, 1988 and March 31, 2018, with follow-up until March 31, 2019. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for cSCC, BCC, and melanoma, comparing use of hydrochlorothiazide with use of other thiazide diuretics overall, by cumulative duration of use, and cumulative dose. RESULTS: After an 8.6-year median follow-up, hydrochlorothiazide was associated with an increased risk of cSCC (HR 1.50, 95% CI 1.06-2.11). HRs increased with cumulative duration of use, with evidence of an association after 5-10 years (HR 2.10, 95% CI 1.20-3.67) and highest after > 10 years (HR 3.70, 95% CI 1.77-7.73). Similarly, HRs increased with cumulative dose, with higher estimates for >/= 100,000 mg (HR 4.96, 95% CI 2.51-9.81). In contrast, hydrochlorothiazide was not associated with an increased risk of BCC (HR 1.01, 95% CI 0.91-1.13) or melanoma (HR 0.82, 95% CI 0.63-1.08), with no evidence of duration- or dose-response relationships. CONCLUSIONS: Use of hydrochlorothiazide was associated with an increased risk of cSCC and with evidence of a duration- and dose-response relationship. In contrast, no association was observed for BCC or melanoma. |
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| ジャーナル名 | Drug safety |
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| 投稿日 | 2020/10/27 |
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| 投稿者 | Rouette, Julie; Yin, Hui; Pottegard, Anton; Nirantharakumar, Krishnarajah; Azoulay, Laurent |
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| 組織名 | Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital,;3755 Cote Sainte-Catherine Road, H-425.1, Montreal, QC, H3T 1E2, Canada.;Department of Epidemiology, Biostatistics, and Occupational Health, McGill;University, Montreal, Canada.;Clinical Pharmacology and Pharmacy, University of Southern Denmark, Odense,;Denmark.;Institute of Applied Health Research, University of Birmingham, Birmingham, UK.;laurent.azoulay@mcgill.ca.;University, Montreal, Canada. laurent.azoulay@mcgill.ca.;Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33104975/ |
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