Calcium channel blockers and cancer risk using the UK CPRD

Lamiae Grimaldi-Bensouda, Mark De Groot, Robert Reynolds, Olaf Klungel, Michel Rossignol

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Abstract

Background: This study was part of the Pharmacoepidemiological Research on Outcomes (PROTECT) project which aims at monitoring of the benefit-risk of medicines in Europe. Few epidemiological studies have investigated the association between calcium channel blockers (CCB) and cancer, and have provided contradictory evidence. Objectives: To investigate whether CCB exposure is associated with cancer risk and whether the risk varies according to cancer subtype and duration of exposure. Methods: A population-based matched-cohort study was conducted using data from the Clinical Practice Research Datalink and National Cancer Registration System. Eligible patients (18 to 79 years, over two years primary care and prescription history) with ≥1 CCB prescription between 1996 and 2009 (CCBC) were compared with two CCB unexposed cohorts: 1) patients without CCB exposure (NCCBC), and; 2) patients with no CCB and ≥1 other antihypertensive prescription (AHTC). CCBC was compared with NCCBC and AHTC according to cancer outcomes. Conditional logistic cox-regression models estimated multivariable hazard ratios (HR) and 95% confidence intervals (CI). Results: There were 150,750 patients in the CCBC, 557,931 in the NCCBC, and 156,966 in the AHTC. Cancer rates (crude per 1000 person-years) were 16.51, 15.75 and 10.62 for the CCBC, NCCBC and AHTC respectively. Adjusted HRs (CI) of all cancer for the CCBC compared to the NCCBC and AHTC were 0.88 (0.86-0.89) and 1.01 (0.98-1.04) respectively. Adjusted HRs (CI) of breast, prostate, and colon cancer for the CCBC compared to the AHTC were 0.95 (0.87-1.04), 1.07 (0.98-1.16) and 0.89 (0.81-0.98) respectively. Adjusted HRs (CI) of all cancer for the CCBC compared to the NCCBC were 0.88 (0.85-0.91), 0.98 (0.93-1.04), and 1.11 (0.98-1.27) for 0 to 5years, 5 to 10years, and ≥10 years of cumulative drug exposure respectively. Conclusions: This study showed strong evidence that CCB use is not associated with cancer. Shorter periods of CCB exposure showed a small protective effect for cancer, as did CCB exposure for colon cancer. Results will be discussed in relation to other findings from PROTECT work package two.
Original languageEnglish
Article number660
Pages (from-to)353
Number of pages1
JournalPharmacoepidemiology and Drug Safety
Volume23
Issue numberS1
DOIs
Publication statusPublished - 1 Oct 2014

Keywords

  • calcium channel blocking agent
  • antihypertensive agent
  • cancer risk
  • United Kingdom
  • pharmacoepidemiology
  • risk management
  • neoplasm
  • male
  • human
  • exposure
  • patient
  • prescription
  • colon cancer
  • risk
  • cohort analysis
  • drug exposure
  • primary medical care
  • proportional hazards model
  • population
  • monitoring
  • prostate
  • breast
  • cancer registry
  • confidence interval
  • hazard ratio
  • clinical practice
  • Europe
  • model

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