Christie Alexander, Vera Pedro L, Higgins Margaret, Kumar Sandeep, Lane Matthew, Preston David
University of Kentucky College of Medicine, Lexington, KY.
University of Kentucky College of Medicine, Lexington, KY; VA Medical Center, Lexington, KY.
Urology. 2019 Apr;126:116-120. doi: 10.1016/j.urology.2019.01.025. Epub 2019 Feb 5.
To examine the relationship between phosphodiesterase 5 inhibitor drugs (PDE5i) and skin cancers in a large-scale study of Veterans.
This was a retrospective database review using the Department of Veterans Affairs Informatics and Computing Infrastructure database. Veterans Affairs Informatics and Computing Infrastructure was searched 19 years for Veterans who received PDE5i treatment of erectile dysfunction. A non-PDE5i group of Veterans was selected for comparison analysis. Follow-up time, outpatient clinic visits and incidence of malignant melanoma (MM), and basal cell carcinoma (BCC) were measured in both groups.
A total of 2.55 million Veterans were included in this study (1.27 million in each group). Mean age of the PDE5i group and non-PDE5i group was 59.2 years (standard deviation [SD] ± 10.8) and 58.7 (SD ± 10.8), respectively. Mean follow-up time for the PDE5i group was 8.9 years (SD ± 4.2) and 8.5 years (SD ± 4.3) for non-PDE5i group. Odds ratio for malignant melanoma and BCC in the PDE5i group was 1.25 (confidence interval 95%, 1.22-1.28, P <.0001) and 1.49 (confidence interval 95%, 1.46-1.51, P <.0001), respectively. PDE5i users showed more mean outpatient visits/year (8.9 SD ± 9.50) compared to non-PDE5i users (5.9 SD ± 10.0; P <.0001).
Veterans prescribed PDE5is to treat erectile show a minimal increased risk of MM and a greater risk of BCC compared to non-PDE5i users. PDE5i users visited outpatient VA clinics at a higher rate than non-PDE5i users in this study. These findings suggest confounding variables are likely involved in the relationship between skin cancers and PDE5i use. PDE5i drugs remain a safe treatment for erectile dysfunction.
在一项针对退伍军人的大规模研究中，探讨磷酸二酯酶5抑制剂药物（PDE5i）与皮肤癌之间的关系。
这是一项利用退伍军人事务部信息学与计算基础设施数据库进行的回顾性数据库审查。对退伍军人事务部信息学与计算基础设施进行了为期19年的搜索，以查找接受PDE5i治疗勃起功能障碍的退伍军人。选择一组未使用PDE5i的退伍军人进行对比分析。对两组的随访时间、门诊就诊次数以及恶性黑色素瘤（MM）和基底细胞癌（BCC）的发病率进行了测量。
本研究共纳入255万名退伍军人（每组127万）。PDE5i组和非PDE5i组的平均年龄分别为59.2岁（标准差[SD]±10.8）和58.7岁（SD±10.8）。PDE5i组的平均随访时间为8.9年（SD±4.2），非PDE5i组为8.5年（SD±4.3）。PDE5i组中恶性黑色素瘤和基底细胞癌的比值比分别为1.25（95%置信区间，1.22 - 1.28，P <.0001）和1.49（95%置信区间，1.46 - 1.51，P <.0001）。与未使用PDE5i的退伍军人相比，使用PDE5i的退伍军人每年的平均门诊就诊次数更多（8.9 SD±9.50），而非PDE5i使用者为5.9 SD±10.0（P <.0001）。
与未使用PDE5i的退伍军人相比，使用PDE5i治疗勃起功能障碍的退伍军人患恶性黑色素瘤的风险略有增加，患基底细胞癌的风险更高。在本研究中，使用PDE5i的退伍军人到退伍军人事务部门诊就诊的频率高于未使用PDE5i的退伍军人。这些发现表明，皮肤癌与使用PDE5i之间的关系可能涉及混杂变量。PDE5i药物仍然是治疗勃起功能障碍的安全药物。
