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Cysteinyl Leukotriene Receptor Antagonists Decrease Cancer Risk in Asthma Patients
Ming-Ju Tsai1,2, Ping-Hsun Wu3,4, Chau-Chyun Sheu1,5
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Abstract:
Previous in vitro and in vivo studies have demonstrated the potential of using cysteinyl leukotriene receptor antagonists (LTRAs) for chemoprevention, but this has not been investigated in any clinical setting. We therefore investigated the chemopreventive effect of LTRAs in a nationwide population-based study. From the Taiwan National Health Insurance Research Database, we enrolled adults with newly-diagnosed asthma between 2001 and 2011. Among these patients, each LTRA user was matched with five randomly-selected LTRA non-users by sex, age, asthma diagnostic year and modified Charlson Comorbidity Index score. We considered the development of cancer as the outcome. Totally, 4185 LTRA users and 20925 LTRA non-users were identified. LTRA users had a significantly lower cancer incidence rate than LTRA non-users did. Multivariable Cox regression analyses adjusting for baseline characteristics and comorbidities showed LTRA use was an independent protecting factor (hazard ratio = 0.31 [95% CI: 0.24-0.39]), and cancer risk decreased progressively with higher cumulative dose of LTRAs. In conclusion, this study revealed that the LTRA use decreased cancer risk in a dose-dependent manner in asthma patients. The chemopreventive effect of LTRAs deserves further study.
Insights
Cysteinyl leukotriene receptor antagonists (LTRAs) show promise in cancer chemoprevention. This study found LTRA use significantly reduced cancer risk in asthma patients, with risk decreasing in a dose-dependent manner.
Area of Science:
- Pharmacology
- Oncology
- Epidemiology
Background:
- In vitro and in vivo studies suggest cysteinyl leukotriene receptor antagonists (LTRAs) have chemopreventive potential.
- Clinical evidence for the chemopreventive effects of LTRAs is lacking.
Purpose of the Study:
- To investigate the chemopreventive effect of LTRAs in a clinical setting.
- To evaluate the association between LTRA use and cancer risk in asthma patients.
Main Methods:
- A nationwide population-based study using the Taiwan National Health Insurance Research Database.
- Matching 4185 LTRA users with 20925 LTRA non-users diagnosed with asthma (2001-2011).
- Multivariable Cox regression analyses to assess cancer incidence and LTRA use, adjusting for covariates.
Main Results:
- LTRA users exhibited a significantly lower cancer incidence rate compared to non-users.
- LTRA use was identified as an independent protective factor against cancer (HR = 0.31).
- Cancer risk decreased progressively with increasing cumulative doses of LTRAs.
Conclusions:
- LTRA use is associated with a reduced cancer risk in asthma patients.
- The chemopreventive effect of LTRAs appears to be dose-dependent.
- Further clinical studies are warranted to explore the chemopreventive role of LTRAs.
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