Key result
Angiotensin receptor blockers were significantly associated with gastric cancer progression (RR 0.63; 95% CI 0.5-0.7; P=0.00), whereas ACE inhibitors showed no significant link.
Why the study?
Angiotensin receptor blockers and angiotensin-converting enzyme inhibitors are widely used for hypertension and cardiovascular disease, but they can increase the risk of cancer progression including gastric cancer.
Does the use of ARBs or ACEIs affect the progression of gastric cancer?
Meta-Analysis
Does the use of ARBs or ACEIs affect the progression of gastric cancer?
Relative Risk: 0.63 (95% CI 0.5–0.7)
p-value: p=0.00
This meta-analysis reports a statistically significant association between ARB use and gastric cancer progression, though the reported risk ratio of 0.63 contradicts the authors' textual conclusion that ARBs increase the risk.
ARBs may slow gastric cancer progression in meta-analyzed data; leaves open need for RCTs before any clinical repurposing.
Angiotensin receptor blockers (ARB), as well as angiotensin-converting enzyme inhibitors (ACEI), are mostly used as therapy for hypertension and cardiovascular disease. However, they can increase the risk of cancer progression including gastric cancer. Here we aimed to analyze the assessment between ARB and ACEI on the progression of gastric cancer. Cochrane Library, PubMed and EMBASE were searched for articles and abstracts describing ARBs, ACEIs, and incidence of gastric cancer. Risk ratio, hazard ratio and 95% confidence interval (CI) were extracted from each outcome by using a random-effects model. Six studies met our inclusion criteria. These results demonstrated that there is a significant association between ARB with gastric cancer progression (risk ratio = 0.63; 95% CI, 0.5-0.7; P = 0.00; I 2 = 27.299; df (Q) = 2; Q-value = 2.75). However, there was not any link between ACEIs and gastric cancer development (risk ratio = 1.1; 95% CI, 0.92-1.31; P = 0.26; I 2 = 0.00; df (Q) = 3; Q-value = 1.26). All these findings indicated that using the ARBs has raised the progression of gastric cancer in these patients.
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Mehrdad et al. (2022) conducted a meta-analysis in gastric cancer. Angiotensin receptor blockers (ARB) and angiotensin-converting enzyme inhibitors (ACEI) vs. Non-users or reference group was evaluated on gastric cancer progression (risk ratio 0.63, 95% CI 0.5-0.7, p=0.00). Angiotensin receptor blockers were significantly associated with gastric cancer progression (RR 0.63; 95% CI 0.5-0.7; P=0.00), whereas ACE inhibitors showed no significant link.
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