| Autor: |
Hamandi, B., Fegbeutel, C., Silveira, F. P., Verschuuren, E. A., Younus, M., Mo, J., Yan, J., Ussetti, P., Chin‐Hong, P. V., Solé, A., Holmes‐Liew, C. L., Billaud, E. M., Grossi, P. A., Manuel, O., Levine, D. J., Barbers, R. G., Hadjiliadis, D., Aram, J., Singer, L. G., Husain, S. |
| Zdroj: |
American Journal of Transplantation; January 2018, Vol. 18 Issue: 1 p113-124, 12p |
| Abstrakt: |
This study evaluated the independent contribution of voriconazole to the development of squamous cell carcinoma (SCC) in lung transplant recipients, by attempting to account for important confounding factors, particularly immunosuppression. This international, multicenter, retrospective, cohort study included adult patients who underwent lung transplantation during 2005‐2008. Cox regression analysis was used to assess the effects of voriconazole and other azoles, analyzed as time‐dependent variables, on the risk of developing biopsy‐confirmed SCC. Nine hundred lung transplant recipients were included. Median follow‐up time from transplantation to end of follow‐up was 3.51 years. In a Cox regression model, exposure to voriconazole alone (adjusted hazard ratio 2.39, 95% confidence interval 1.31‐4.37) and exposure to voriconazole and other azole(s) (adjusted hazard ratio 3.45, 95% confidence interval 1.07‐11.06) were associated with SCCcompared with those unexposed after controlling for important confounders including immunosuppressants. Exposure to voriconazole was associated with increased risk of SCCof the skin in lung transplant recipients. Residual confounding could not be ruled out because of the use of proxy variables to control for some confounders. Benefits of voriconazole use when prescribed to lung transplant recipients should be carefully weighed versus the potential risk of SCC.
EU PAS registration number: EUPAS5269. This multicenter, retrospective, cohort study found a 2.4‐fold increased risk of squamous cell carcinoma in lung transplant recipients exposed to voriconazole compared to unexposed recipients. See page 5for Kulkarni and Witt's comments. |
| Databáze: |
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