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Association Between the Use of Topical Calcineurin Inhibitors and the Risk of Cancer Among Patients with Atopic

Hao-Hsin Huang1,2, Dereck Shen1, Tom C Chan3

  • 1School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.

American Journal of Clinical Dermatology
|June 6, 2023
PubMed
Abstract

Insights

Topical calcineurin inhibitors (TCIs) show no increased cancer risk in atopic dermatitis (AD) patients compared to topical corticosteroids (TCSs), except for a potential leukemia risk. This study provides crucial insights for Asian populations.

Area of Science:

  • Dermatology and Oncology
  • Epidemiology
  • Pharmacovigilance

Background:

  • The association between topical calcineurin inhibitors (TCIs) and cancer risk in atopic dermatitis (AD) patients is debated.
  • Limited data exists on TCI-related cancer risks specifically within Asian populations.

Purpose of the Study:

  • To investigate the association between TCI use and the risk of developing various cancers, including lymphoma, skin cancers, and others, in patients with AD.
  • To provide population-based evidence on TCI safety in an Asian demographic.

Main Methods:

  • A nationwide, population-based, retrospective cohort study utilizing Taiwan's National Health Insurance Research Database.
  • Included patients with AD (ICD-9 codes 691 or 692.9) treated between 2003-2010, followed until 2018.
  • Compared TCI users (tacrolimus, pimecrolimus) with topical corticosteroid (TCS) users using propensity score matching and Cox proportional hazard models.

Main Results:

  • After propensity score matching, 195,925 patients (39,185 TCI users, 156,740 TCS users) were analyzed.
  • No significant association was found between TCI use and the risk of overall cancer, lymphoma, or skin cancers.
  • A potential increased risk of leukemia was observed with TCI use, consistent across sensitivity analyses.

Conclusions:

  • Topical calcineurin inhibitor use in AD patients is not associated with an increased risk of most cancers compared to topical corticosteroids.
  • Physicians should remain aware of a potential elevated risk of leukemia associated with TCI treatment.
  • This study is the first population-based investigation of TCI-related cancer risk in an Asian population with AD.

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