Key result
Use of renin-angiotensin-aldosterone system inhibitors was associated with lower pancreatic cancer mortality (combination therapy OR 0.83; 95% CI 0.70-0.97; p=0.022), but did not impact cancer risk.
Why the study?
Pancreatic cancer is one of the most malignant and invasive neoplasms globally, motivating this evaluation of the relationship between renin-angiotensin-aldosterone system inhibitor use and pancreatic cancer incidence and mortality.
Does the use of renin-angiotensin-aldosterone system inhibitors reduce the risk and mortality of pancreatic cancer?
Systematic Review (n=335,339)
Does the use of renin-angiotensin-aldosterone system inhibitors reduce the risk and mortality of pancreatic cancer?
Odds Ratio: 0.83 (95% CI 0.7–0.97)
p-value: p=0.022
RAAS inhibitors do not appear to affect the incidence of pancreatic cancer but may be associated with reduced mortality in patients who develop it.
BACKGROUND: Pancreatic Cancer (PC) is one of the most malignant tumors and highly invasive neoplasms around the world. OBJECTIVE: This systematic review and meta-analysis aims to study the relationship between the use of renin-angiotensin-aldosterone system inhibitors and the incidence and mortality of PC. METHODS: ), Forest plots, and publication bias tests (Begg's and Egger's tests). RESULTS: A total of four studies (2011-2019; n=314,856) investigated the relationship between RAS antagonists and PC risk. No significant associations were found between angiotensin receptor blockers (ARBs) (OR=0.94, 95% CI: 0.77-1.14, p=0.513), angiotensin-converting enzyme inhibitors (ACEIs) (OR=0.96, 95% CI: 0.84-1.09, p=0.505), or combination therapy (ARBs + ACEIs) (OR=0.97, 95% CI: 0.87-1.09, p=0.627) and PC risk. Also, nine studies (2010-2023; n=20,483) examined the association between renin-angiotensin-aldosterone system inhibitors and PC mortality. Significant reductions in PC mortality were found for ARBs (OR=0.81, 95% CI: 0.66-0.98, p=0.032), ACEIs (OR=0.89, 95% CI: 0.80-0.99, p=0.038), and combination therapy (OR=0.83, 95% CI: 0.70-0.97, p=0.022). No evidence of publication bias was found in the study results. CONCLUSION: In summary, while renin-angiotensin-aldosterone system inhibitors did not appear to impact PC risk, their use was associated with lower PC mortality based on this meta-analysis of the current evidence. More rigorous and well-designed studies are required to validate and support these findings.
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Rahimi et al. (2024) conducted a systematic review in Pancreatic Cancer (n=335,339). Renin-angiotensin-aldosterone system inhibitors vs. No use of renin-angiotensin-aldosterone system inhibitors was evaluated on Pancreatic cancer mortality (combination therapy) (OR 0.83, 95% CI 0.70-0.97, p=0.022). Use of renin-angiotensin-aldosterone system inhibitors was associated with lower pancreatic cancer mortality (combination therapy OR 0.83; 95% CI 0.70-0.97; p=0.022), but did not impact cancer risk.
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