Center for Primary Health Care Research, Lund University/Region Skåne, Lund, Sweden.
Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Int J Cancer. 2019 Apr 15;144(8):1888-1895. doi: 10.1002/ijc.31901. Epub 2018 Nov 4.
Terbinafine is used for the treatment of several superficial fungal infections. In silico analyses and animal models suggest that terbinafine might have an anti-tumor effect. We aimed to explore whether subsequent administration of terbinafine might be associated with a lower mortality rate in patients with prostate cancer. We identified patients diagnosed with prostate cancer between July 2005 and December 2014 from the Swedish Cancer Registry, and linked them to the Swedish Prescribed Drug Register to ascertain subsequent use of terbinafine. A total of 799 patients received oral treatment of terbinafine during the study period with a mortality rate of 18.6 per 1,000 person-years. Compared to patients who did not use terbinafine and adjusting for a range of confounding factors, patients that received oral treatment of terbinafine had a decreased risk of death from prostate cancer (HR, 0.53; 95% CI, 0.38-0.73) and a decreased risk of death overall (HR, 0.64; 95% CI, 0.52-0.77). To account for indication bias, we further identified 907 patients who received topical use of terbinafine. However, the risk of death from prostate cancer in patients with topical use of terbinafine was 0.92 (95% CI 0.74-1.12) and the risk of death overall was 1.03 (95% CI 0.91-1.17) as compared to the controls, which suggests that there was no association between risk of death in patients with prostate cancer with topical use of terbinafine. These findings suggest that this drug's potential anti-tumor effect needs to be explored further.
特比萘芬用于治疗几种浅部真菌感染。计算机模拟分析和动物模型表明，特比萘芬可能具有抗肿瘤作用。我们旨在探讨在前列腺癌患者中，后续应用特比萘芬是否与较低的死亡率相关。
我们从瑞典癌症登记处确定了 2005 年 7 月至 2014 年 12 月期间被诊断患有前列腺癌的患者，并与瑞典处方药物登记处联系以确定随后使用特比萘芬的情况。在研究期间，共有 799 名患者接受了特比萘芬的口服治疗，死亡率为每 1000 人年 18.6 人。与未使用特比萘芬的患者相比，并调整了一系列混杂因素后，接受口服特比萘芬治疗的患者死于前列腺癌的风险降低（HR，0.53；95%CI，0.38-0.73），死于总死亡率的风险也降低（HR，0.64；95%CI，0.52-0.77）。为了考虑指示偏差，我们进一步确定了 907 名接受特比萘芬局部应用的患者。然而，与对照组相比，接受特比萘芬局部应用的患者死于前列腺癌的风险为 0.92（95%CI，0.74-1.12），死于总死亡率的风险为 1.03（95%CI，0.91-1.17），这表明前列腺癌患者局部应用特比萘芬与死亡风险之间没有关联。
这些发现表明，这种药物的潜在抗肿瘤作用需要进一步探索。
