Department of Child Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan.
Department of Medicine, Chang Gung University, Taoyuan, Taiwan.
Cancer Med. 2019 Aug;8(9):4484-4496. doi: 10.1002/cam4.2329. Epub 2019 Jun 10.
The association between antipsychotic use and gastric cancer risk remains unclear. Therefore, this study aimed to determine the association between antipsychotic exposure and the incidence of gastric cancer.
Using a nested case-control design, a total of 34 470 gastric cancer patients and 163 430 nongastric cancer controls were identified from Taiwan's National Health Insurance Research Database between 1 January 1997 and 31 December 2013. We analyzed the data using a conditional logistic regression model to adjust for possible confounding variables.
Antipsychotic use was independently inversely associated with gastric cancer risk after controlling for potential confounding factors including income, urbanization, medications, physical and medical illness, aspirin use, nonsteroidal anti-inflammatory drug use and triple therapy. In addition, dose-dependent trends against gastric cancer risk were also shown with individual antipsychotic compounds including thioridazine, haloperidol, sulpiride, clozapine, olanzapine, quetiapine, amisulpride, and risperidone. A sensitivity analysis showed that second-generation antipsychotics had significant dose-dependent effects in reducing the risk of gastric cancer risk in patients with and without peptic ulcer disease.
Antipsychotic use was inversely associated with gastric cancer risk, and dose-dependent effects against gastric cancer were also seen with several individual antipsychotic compounds.
抗精神病药物的使用与胃癌风险之间的关联尚不清楚。因此,本研究旨在确定抗精神病药物暴露与胃癌发病风险之间的关系。
本研究采用巢式病例对照设计,从 1997 年 1 月 1 日至 2013 年 12 月 31 日,从台湾全民健康保险研究数据库中确定了 34470 例胃癌患者和 163430 例非胃癌对照。我们使用条件逻辑回归模型分析数据,以调整可能的混杂因素。
在控制了收入、城市化程度、药物、身体和医疗疾病、阿司匹林使用、非甾体抗炎药使用和三联疗法等潜在混杂因素后,抗精神病药物的使用与胃癌风险呈独立负相关。此外,还显示了个体抗精神病药物化合物(包括硫利达嗪、氟哌啶醇、舒必利、氯氮平、奥氮平、喹硫平、氨磺必利和利培酮)与胃癌风险呈剂量依赖性趋势。敏感性分析表明,第二代抗精神病药物在患有和不患有消化性溃疡病的患者中均具有显著的剂量依赖性降低胃癌风险的作用。
抗精神病药物的使用与胃癌风险呈负相关,几种个体抗精神病药物化合物也与胃癌风险呈剂量依赖性关系。