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March 2, 2022PLoS ONEOpen Access

Risk of cancer with angiotensin-receptor blockers increases with increasing cumulative exposure: Meta-regression analysis of randomized trials

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Why the study?

Randomized trials yielded conflicting results on whether ARBs increase cancer risk, and regulatory agencies recently identified potential carcinogens in multiple formulations.

Does cumulative exposure to angiotensin-receptor blockers increase the risk of cancer in patients?

Population

74,021 patients randomized to an ARB and 61,197 to control across 15 randomized controlled trials

Comparison

Varying degrees of cumulative exposure to ARBs vs control

Design

Meta-regression analysis of trial-level data from randomized controlled trials

Authors

İSİlke SipahiCleveland Clinic

Discussion

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Implication

May warrant caution with prolonged high-dose ARB use; confirms exposure-dependent cancer risk in randomized trials.

Structured PICO

Does cumulative exposure to angiotensin-receptor blockers increase the risk of cancer in patients?

P
Population
135,218 patients from 15 randomized controlled trials (74,021 randomized to ARB, 61,197 to control)
I
Intervention
Angiotensin-receptor blockers (ARBs) with varying cumulative exposure (total cumulative exposure of 172,389 person-years of exposure to daily high dose or equivalent)
C
Comparator
Control (placebo or non-placebo control)
O
Outcome
Relationship between cumulative exposure to ARBs and risk of all cancers combined, and relationship between cumulative exposure and risk of lung cancersafety

The risk of all cancers combined and specifically lung cancer increases with increasing cumulative exposure to angiotensin-receptor blockers.

Limitations

  • Trial-level analysis
  • Effects of patient characteristics such as age and smoking status could not be examined due to lack of patient-level data

Cite This Study

İlke Sipahi (2022) studied this question.

synapsesocial.com/papers/6a71a10b53da1ffdb507c1c7https://doi.org/10.1371/journal.pone.0263461

Topics

Hypertension management
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