Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA.
Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.
Drug Saf. 2018 Feb;41(2):161-169. doi: 10.1007/s40264-017-0599-x.
Several antihypertensive drugs are photosensitizing and may promote the development of malignant melanoma (MM), but evidence remains inconsistent. We sought to quantify the association between use of antihypertensive drugs and MM risk.
We systematically searched PubMed, Embase, and CENTRAL from inception to August 17, 2017 to identify observational studies that reported the MM risk associated with the use of antihypertensive drugs. A random-effects meta-analysis was used to estimate the odds ratio (OR) with 95% confidence interval (CI).
Overall, we included eight observational studies (two cohort studies and six case-control studies). Compared with non-use, use of diuretics (OR 1.10; 95% CI 1.03-1.17) or β-adrenergic blocking agents (OR 1.19; 95% CI 1.04-1.37) was significantly associated with increased risk of MM. The use of angiotensin-converting enzyme inhibitors (OR 1.08; 95% CI 0.95-1.23), angiotensin II receptor blockers (OR 1.12; 95% CI 0.95-1.31), and calcium channel blockers (OR 1.12; 95% CI 0.72-1.74) was not significantly associated with increased risk of MM.
Current evidence from observational studies suggests that use of diuretics or β-adrenergic blocking agents may be associated with increased risk of MM. Further large well-conducted prospective studies are required to confirm our findings.
几种降压药具有光敏性,可能会促进恶性黑色素瘤(MM)的发展,但证据仍不一致。我们旨在定量评估使用降压药与 MM 风险之间的相关性。
我们从建库至 2017 年 8 月 17 日系统性检索了 PubMed、Embase 和 CENTRAL,以确定报告与使用降压药相关的 MM 风险的观察性研究。采用随机效应荟萃分析来估计比值比(OR)及其 95%置信区间(CI)。
总体而言,我们纳入了 8 项观察性研究(2 项队列研究和 6 项病例对照研究)。与不使用者相比,利尿剂(OR 1.10;95%CI 1.03-1.17)或β肾上腺素能阻滞剂(OR 1.19;95%CI 1.04-1.37)的使用者发生 MM 的风险显著增加。血管紧张素转换酶抑制剂(OR 1.08;95%CI 0.95-1.23)、血管紧张素 II 受体阻滞剂(OR 1.12;95%CI 0.95-1.31)和钙通道阻滞剂(OR 1.12;95%CI 0.72-1.74)的使用者与 MM 风险增加无关。
目前观察性研究的证据表明,使用利尿剂或β肾上腺素能阻滞剂可能与 MM 风险增加相关。需要进一步开展大型、精心设计的前瞻性研究来证实我们的发现。