Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Pharmacoepidemiol Drug Saf. 2023 Jul;32(7):726-734. doi: 10.1002/pds.5596. Epub 2023 Feb 21.
To examine the association between long-term use of dopamine agonists (DAs) and the risk of lung cancer in patients with restless legs syndrome (RLS).
We conducted a retrospective cohort study using Optum Clinformatics® database. We included adults ≥40 years diagnosed with RLS during the study period (1/2006-12/2016). Follow-up started with the first RLS diagnosis and ended on the earliest of: incident diagnosis of lung cancer, end of enrollment in the database or end of the study period. The exposure of interest was cumulative duration of DAs use, measured in a time-varying manner. We constructed a multivariable Cox regression model to estimate HRs and 95% CIs for the association between lung cancer and cumulative durations of DA use, adjusting for potential confounding variables.
We identified 295 042 patients with a diagnosis of RLS. The mean age of the cohort was 62.9; 66.6% were women and 82.3% were white. The prevalence of any DA exposure was 40.3%. Compared to the reference group (no use and ≤1 year), the crude HRs for lung cancer were 1.16 (95% CI 0.99-1.36) and 1.14 (95% CI 0.86-1.51) for 1-3 years and >3 years of cumulative DA use, respectively. The adjusted HR for lung cancer was 1.05 (95% CI 0.88-1.25) for 1-3 years and 1.02 (95% CI 0.76-1.37) for >3 years of cumulative DA use, respectively.
At typical doses for the clinical management of RLS, long-term DA use was not associated with risk of lung cancer.
研究长期使用多巴胺激动剂（DAs）与不安腿综合征（RLS）患者肺癌风险之间的关系。
我们使用 Optum Clinformatics®数据库进行了一项回顾性队列研究。我们纳入了在研究期间（2006 年 1 月至 2016 年 12 月）被诊断为 RLS 的年龄≥40 岁的成年人。随访从首次 RLS 诊断开始，以下列最早时间结束：肺癌的确诊、数据库入组结束或研究期结束。感兴趣的暴露是使用 DAs 的累积时间，以时变方式测量。我们构建了多变量 Cox 回归模型，以估计肺癌与 DA 使用累积时间之间的关联的 HR 和 95%置信区间，同时调整了潜在混杂变量。
我们确定了 295042 例 RLS 诊断患者。队列的平均年龄为 62.9 岁；66.6%为女性，82.3%为白人。任何 DA 暴露的患病率为 40.3%。与参考组（无暴露和使用时间≤1 年）相比，1-3 年和>3 年累积 DA 使用的肺癌粗 HR 分别为 1.16（95%CI 0.99-1.36）和 1.14（95%CI 0.86-1.51）。肺癌的调整 HR 分别为 1-3 年累积 DA 使用 1.05（95%CI 0.88-1.25）和>3 年累积 DA 使用 1.02（95%CI 0.76-1.37）。
在用于 RLS 临床管理的典型剂量下，长期使用 DA 与肺癌风险无关。
