Melanoma and Non-Melanoma Skin Cancer Associated with Angiotensin-Converting-Enzyme Inhibitors, Angiotensin-Receptor Blockers and Thiazides: A Matched Cohort Study

Beatrice Nardone, Sara Majewski, Ashley S. Kim, Tina Kiguradze, Estela M. Martinez-Escala, Rivka Friedland, Ahmad Amin, Anne E. Laumann, Beatrice J. Edwards, Alfred W. Rademaker, Mary C. Martini and Dennis P. West ()
Additional contact information
Beatrice Nardone: Northwestern University
Sara Majewski: Northwestern University
Ashley S. Kim: Northwestern University
Tina Kiguradze: Northwestern University
Estela M. Martinez-Escala: Northwestern University
Rivka Friedland: Northwestern University
Ahmad Amin: Northwestern University
Anne E. Laumann: Northwestern University
Beatrice J. Edwards: University of Texas MD Anderson Cancer Center
Alfred W. Rademaker: Northwestern University
Mary C. Martini: Northwestern University
Dennis P. West: Northwestern University

Drug Safety, 2017, vol. 40, issue 3, No 6, 249-255

Abstract: Abstract Introduction Controversy exists about an association between angiotensin-converting-enzyme inhibitors (ACEIs), angiotensin-receptor blockers (ARBs), and thiazides (TZs) and the risk of malignant melanoma (MM), and non-melanoma skin cancer—basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Objective The aim of this study was to determine if an association exists for ACEI, ARB, or TZ exposure and skin cancers. Methods This was a matched cohort study using a large electronic medical records repository, the Northwestern Medicine Enterprise Data Warehouse (NMEDW). The exposed population consisted of patients with a documented order for an ACEI, ARB, or TZ with no prior history of skin cancer. The control population consisted of matched patients without documented exposure to ACEI, ARB, or TZ and no previous skin cancer. Incident MM, BCC, or SCC diagnosis by ICD-9 codes was recorded. Odds ratios (ORs) were obtained by using logistic regression analyses. Results Among the 27,134 patients exposed to an ACEI, 87 MM, 533 BCC, and 182 SCC were detected. Among the 13,818 patients exposed to an ARB, 96 MM, 283 BCC, and 106 SCC were detected. Among the 15,166 patients exposed to a TZ, 99 MM, 262 BCC, and 130 SCC were detected. Significant associations using ORs from logistic regression were found for MM and TZs (OR 1.82; 95% confidence interval [CI] 1.01–3.82); BCC and ARBs (OR 2.86; 95% CI 2.13–3.83), ACEIs (OR 2.23; 95% CI 1.78–2.81) and TZs (OR 2.11; 95% CI 1.60–2.79); SCC and ARBs (OR 2.22; 95% CI 1.37–3.61), ACEIs (OR 1.94; 95% CI 1.37–2.76), and TZs (OR 4.11; 95% CI 2.66–6.35). Conclusions A safety signal for ACEIs, ARBs, and TZs and BCC and SCC, as well as for TZs and MM, was detected. An increased awareness and education, especially for those who are at high risk for skin cancer, are warranted for patients and healthcare providers. Further exploration of such associations for these commonly used drug classes is warranted.

Keywords: Malignant Melanoma; Squamous Cell Carcinoma; Skin Cancer; Basal Cell Carcinoma; Electronic Health Record (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s40264-016-0487-9

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