Löfling Lukas, Sundström Anders, Kieler Helle, Bahmanyar Shahram, Linder Marie
Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institute, Solna, Sweden,
Clin Epidemiol. 2019 Jan 23;11:133-143. doi: 10.2147/CLEP.S186842. eCollection 2019.
One out of six adults has symptoms of overactive bladder (OAB). Antimuscarinic medication is the main pharmacological group used in the treatment of OAB. In preclinical studies, antimuscarinic compounds have been found to inhibit cell proliferation in lung cancer and colon cancer.
The aim of this study was to investigate the association between exposure to anti-muscarinic medication and the risk of lung cancer and colon cancer.
Individuals in Sweden who first filled a prescription for an antimuscarinic medication used to treat OAB (ie, oxybutynin, solifenacin, darifenacin, fesoterodine, or tolterodine) between July 1, 2006, and December 31, 2012, were identified and classified as exposed. Each exposed individual was individually matched with up to ten unexposed individuals from the Swedish general population, based on year of birth, sex, and county of residence. Cox proportional hazard models with follow-up time as the underlying time scale were used to estimate HRs with 95% CIs.
In total, 164,000 exposed and 1,446,472 unexposed individuals were included in this study. The estimated HRs for lung cancer, in follow-up time intervals of <1 year, 1-4 years, and ≥4 years, were as follows: 0.86 (95% CI: 0.75-0.98), 0.63 (95% CI: 0.56-0.70), and 0.43 (0.34-0.55), respectively. The corresponding estimates for colon cancer were as follows: 0.91 (95% CI: 0.80-1.03), 0.81 (95% CI: 0.74-0.88), and 0.61 (95% CI: 0.51-0.73), respectively.
There was an inverse association between exposure to antimuscarinic medications, used in the treatment of OAB, and a diagnosis of colon cancer or lung cancer, which is in line with the findings in preclinical studies.
每六名成年人中就有一人出现膀胱过度活动症(OAB)症状。抗毒蕈碱药物是治疗OAB的主要药物类别。在临床前研究中,已发现抗毒蕈碱化合物可抑制肺癌和结肠癌的细胞增殖。
本研究旨在调查接触抗毒蕈碱药物与患肺癌和结肠癌风险之间的关联。
确定2006年7月1日至2012年12月31日期间首次开具用于治疗OAB的抗毒蕈碱药物(即奥昔布宁、索利那新、达非那新、非索罗定或托特罗定)处方的瑞典人,并将其分类为暴露组。根据出生年份、性别和居住县,将每名暴露个体与多达十名来自瑞典普通人群的未暴露个体进行个体匹配。以随访时间为基本时间尺度的Cox比例风险模型用于估计风险比(HR)及95%置信区间(CI)。
本研究共纳入164,000名暴露个体和1,446,472名未暴露个体。在随访时间间隔<1年、1 - 4年和≥4年时,肺癌的估计HR分别如下:0.86(95%CI:0.75 - 0.98)、0.63(95%CI:0.56 - 0.70)和0.43(0.34 - 0.55)。结肠癌的相应估计值分别如下:0.91(95%CI:0.80 - 1.03)、0.81(95%CI:0.74 - 0.88)和0.61(95%CI:0.51 - 0.73)。
用于治疗OAB的抗毒蕈碱药物暴露与结肠癌或肺癌诊断之间存在负相关,这与临床前研究结果一致。