Use of an emulated trial to investigate the association between use of nitrogen-based bisphosphonates and risk of epithelial ovarian cancer
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View abstract on PubMed
Summary
This summary is machine-generated.Continuing nitrogen-based bisphosphonate (NBB) use in women over 50 was linked to a lower risk of epithelial ovarian cancer (EOC). This study suggests NBBs may offer a protective effect against EOC, particularly serous types.
Area Of Science
- Oncology
- Pharmacology
- Epidemiology
Background
- Epithelial ovarian cancer (EOC) is a leading cause of cancer death in women.
- Observational studies suggest nitrogen-based bisphosphonates (NBBs) may reduce EOC risk, but confounding by indication is a challenge.
- Emulating a target trial provides a robust method to assess NBBs' chemo-preventive potential.
Purpose Of The Study
- To investigate the association between continued use of nitrogen-based bisphosphonates (NBBs) and the risk of epithelial ovarian cancer (EOC).
- To emulate a target trial using real-world data to overcome confounding by indication.
- To assess the risk of EOC, overall and by histotype, in women who initiated NBB treatment.
Main Methods
- Population-based linked data from Australian women aged over 50 initiating NBBs (2004-2012) were analyzed.
- Treatment groups (continued vs. discontinued NBB use) were defined one year after initiation.
- Stabilized inverse probability weights were used to emulate randomization, balancing covariates.
- Flexible parametric time-to-event models assessed EOC risk, allowing for time-varying effects.
Main Results
- The study included 313,383 women, with 472 diagnosed with EOC.
- Continued NBB use was associated with a reduced risk of overall EOC (HR=0.87) and serous EOC (HR=0.71).
- These risk reductions remained consistent over the 9-year follow-up period.
Conclusions
- Women who continued NBB treatment after initiation had a 13% lower hazard of overall EOC diagnosis.
- A 29% lower hazard of serous EOC diagnosis was observed in continued NBB users compared to discontinuers.
- These findings from an emulated trial support a potential chemo-preventive role for NBBs in EOC.
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