甲的使用和皮肤癌的风险:一个基于人口的回顾性队列研究
Avery Shuei-He Yang1, Leila Djebarri2, Chaw Ning Lee1,3
1School of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pharmacoepidemiology and drug safety
|October 24, 2024
概括
在亚洲人群中,使用甲酸 (HCTZ) 并没有显著增加基底细胞癌 (BCC) 的风险. 虽然HCTZ的状细胞癌 (SCC) 风险似乎更高,但这种关联在统计学上并不显著,这表明在处方这些药物时对皮肤癌的担忧较低.
科学领域:
- 皮肤病学 皮肤病学
- 药理学 药理学 是一个学科.
- 流行病学 流行病学
背景情况:
- 甲 (HCTZ) 是一种常见的利尿剂,用于治疗高血压.
- 以前在高加索人群中进行的研究表明,HCTZ与状细胞癌 (SCC) 风险增加之间存在联系,但不是基底细胞癌 (BCC).
- 亚洲人群中与HCTZ相关的皮肤癌风险仍然不太了解.
研究的目的:
- 评估和比较与其他抗高血压药物相比,与HCTZ使用相关的皮肤癌,特别是SCC和BCC的风险.
- 研究不同族群之间与HCTZ相关的皮肤癌风险的潜在差异.
主要方法:
- 使用台湾国家健康保险研究数据库进行了一项回顾性队列研究.
- 包括在2004年至2015年期间开始抗高血压治疗的20岁及以上的患者.
- 超过2年的药物占有率 (MPR) 确定了资格 (MPR>80%). 患者按抗高血压类型 (HCTZ,其他 thiazides,非 thiazide 利尿剂,非利尿剂抗高血压剂) 分类. 考克斯的比例危险模型评估了皮肤癌风险 (SCC和BCC).
主要成果:
- 该研究包括每个药物类别的大队伍:HCTZ (41,086),其他 thiazides (27,402),非 thiazide 利尿剂 (19,613) 和非利尿剂抗高血压剂 (856,782).
- 在HCTZ使用者和其他抗高血压药物的使用者之间,在基础细胞癌 (BCC) 风险上没有显著差异 (调整后的危险比率从0.84到0.93).
- 与其他抗高血压药物 (调整后的危险比率从1.23到1.32) 相比,HCTZ发现了状细胞癌 (SCC) 的风险增加,但置信区间很宽,超过了零值,表明缺乏统计意义.
结论:
- 皮肤癌,包括SCC和BCC,在向亚洲人口开处方抗高血压药时,似乎并不是医生主要关注的问题.
- 这些发现表明,在高加索人群中先前观察到的HCTZ和SCC之间的关联可能不会直接转化为亚洲人群.
- 用更大的样本大小和更长的随访期进行进一步的研究可能是有必要的,以证实这些发现.
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