Jeon Ha-Lim, Lee Seon Hee, Nam Jin Hyun, Shin Ju-Young
School of Pharmacy and Institute of New Drug Development, Jeonbuk National University, Jeonju, Republic of Korea.
School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea.
Cancer Epidemiol. 2022 Oct;80:102245. doi: 10.1016/j.canep.2022.102245. Epub 2022 Sep 7.
Despite valsartan's widespread use, few studies have explored its potential carcinogenicity. We evaluated the association between valsartan and cancer.
We conducted a retrospective cohort study using data from 2002 to 2015 gathered from the National Health Insurance database. Patients with hypertension aged ≥ 30 who used valsartan or other angiotensin II receptor blockers (ARBs) were included. Eligible patients were those with no prior history of the use of any ARBs, diagnosis of cancer, or organ transplantation in the 4 years predating their first use of the drugs of interest. The primary and secondary outcomes included the occurrence of all cancers and site-specific solid cancers, respectively. After applying propensity score (PS) matching, Cox regression was used to calculate the hazard ratios (HRs) and 95 % confidence intervals (CIs).
A total of 1,550,734 individuals were identified as new users of valsartan or other ARBs. Of the 153,047 valsartan users, 16,047 were diagnosed with cancer. No increased risk of overall cancer was observed in valsartan users as compared to other ARB users (aHR = 1.00; 95 % CI, 0.98-1.02). Valsartan was, however, associated with a slightly elevated risk of liver (aHR = 1.09; 95 % CI, 1.01-1.16) and kidney cancer (aHR = 1.11; 95 % CI, 1.02-1.22).
Compared with other ARBs, valsartan did not increase the risk of overall cancer. A slightly increased risk for some solid cancers was associated with valsartan use, though the absolute rate difference was small.
尽管缬沙坦被广泛使用，但很少有研究探讨其潜在的致癌性。我们评估了缬沙坦与癌症之间的关联。
我们进行了一项回顾性队列研究，使用了2002年至2015年从国民健康保险数据库收集的数据。纳入年龄≥30岁且使用缬沙坦或其他血管紧张素II受体阻滞剂（ARB）的高血压患者。符合条件的患者是那些在首次使用感兴趣的药物之前4年内没有使用过任何ARB、没有癌症诊断或器官移植史的患者。主要和次要结局分别包括所有癌症和特定部位实体癌的发生情况。应用倾向评分（PS）匹配后，使用Cox回归计算风险比（HR）和95%置信区间（CI）。
共有1,550,734人被确定为缬沙坦或其他ARB的新使用者。在153,047名缬沙坦使用者中，有16,047人被诊断患有癌症。与其他ARB使用者相比，缬沙坦使用者未观察到总体癌症风险增加（校正HR = 1.00；95% CI，0.98 - 1.02）。然而，缬沙坦与肝癌风险略有升高（校正HR = 1.09；95% CI，1.01 - 1.16）和肾癌风险升高（校正HR = 1.11；95% CI，1.02 - 1.22）有关。
与其他ARB相比，缬沙坦不会增加总体癌症风险。虽然绝对发生率差异很小，但缬沙坦使用与某些实体癌风险略有增加有关。
