Medication use and survival in diabetic patients with kidney cancer: A population-based cohort study
| Autor: | Madhur Nayan, Girish S. Kulkarni, Peter C. Austin, David N. Juurlink, Antonio Finelli, Robert J. Hamilton, Erin M. Macdonald |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Statin medicine.drug_class Population 030232 urology & nephrology Antineoplastic Agents 03 medical and health sciences 0302 clinical medicine Risk Factors Diabetes mellitus Internal medicine Diabetes Mellitus medicine Humans Risk factor education Aged Proportional Hazards Models Retrospective Studies Pharmacology education.field_of_study business.industry Hazard ratio Cancer medicine.disease Kidney Neoplasms Surgery Survival Rate 030220 oncology & carcinogenesis Female business Kidney cancer Cohort study |
| Zdroj: | Pharmacological Research. 113:468-474 |
| ISSN: | 1043-6618 |
| Popis: | Survival rates in kidney cancer have improved little over time, and diabetes may be an independent risk factor for poor survival in kidney cancer. We sought to determine whether medications with putative anti-neoplastic properties (statins, metformin and non-steroidal anti-inflammatory drugs (NSAIDs)) are associated with survival in diabetics with kidney cancer. We conducted a population-based cohort study utilizing linked healthcare databases in Ontario, Canada. Patients were aged 66 or older with newly diagnosed diabetes and a subsequent diagnosis of incident kidney cancer. Receipt of metformin, statins or NSAIDs was defined using prescription claims. The primary outcome was all-cause mortality and the secondary outcome was cancer-specific mortality. We used multivariable Cox proportional hazard regression, with medication use modeled with time-varying and cumulative exposure analyses to account for intermittent use. During the 14-year study period, we studied 613 patients. Current statin use was associated with a markedly reduced risk of death from any cause (adjusted hazard ratio 0.74; 95% CI 0.59–0.91) and death due to kidney cancer (adjusted hazard ratio 0.71; 95% CI 0.51–0.97). However, survival was not associated with current use of metformin or NSAIDs, or cumulative exposure to any of the medications studied. Among diabetic patients with kidney cancer, survival outcomes are associated with active statin use, rather than total cumulative use. These findings support the use of randomized trials to confirm whether diabetics with kidney cancer should be started on a statin at the time of cancer diagnosis to improve survival outcomes. |
| Databáze: | OpenAIRE |
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