Table 6.
Summary of key studies to date investigating associations between angiotensin receptor blocker (ARB) use and cancer outcomes
| Exposed to ARB/total | Description | Main comparison group | Cancer result | ||
|---|---|---|---|---|---|
| Any | Site specific | ||||
| Trial data | |||||
| Pfeffer, 20032 | 3803/7601 | CHARM efficacy trial | Placebo | Fatal: 2.3% v 1.6%, P=0.038; non-fatal: 5.1% v 4.6%, P=0.49 | — |
| Meta-analyses of randomised trials | |||||
| ARB trialists collaboration, 20114 | 73 808/138 760 | Trials of antihypertensive drugs; individual patient data/tabulated data on cancer outcomes available | Placebo (11 trials); ACE inhibitor (2 trials); others (2 trials) | 1.00 (0.95 to 1.04)* | Lung: 1.01 (0.90 to 1.14); prostate: 1.04 (0.93 to 1.16); breast: 1.08 (0.92 to 1.27)* |
| Bangalore, 20117 | 41 454/324 168 | Trials of antihypertensive drugs with reported data on cancer outcomes, or where such information could be obtained from investigators | Mixed control groups | 1.01 (0.93 to 1.09)* v placebo | — |
| Sipahi, 20103 | 35 015/61 590 | Trials of ARB with reported data on cancer outcomes | Placebo (3 trials); ACE inhibitor (1 trial); other (1 trial) | 1.08 (1.01 to 1.15)† | Lung: 1.25, 1.05 to 1.49); prostate: 1.15 (0.99 to 1.34); breast: 0.99 (0.74 to 1.32)† |
| Coleman, 20088 | 9550/126 137 | Trials of antihypertensive drugs reporting data on overall cancer incidence | Mixed control groups | 1.12 (0.87 to 1.47)* v placebo | — |
| Observational studies | |||||
| Pasternak, 20116 | 107 466/317 158 | Database study with Danish registry data, including those with record of ARB or ACE inhibitor use | ACE inhibitor users | 0.99 (0.95 to 1.03)† | Lung: 0.92 (0.82 to 1.02); male genital organs: 1.15 (1.02 to 1.28); breast: 1.01 (0.90 to 1.13); digestive organs: 0.96 (0.88 to 1.04)† |
| Huang, 20115 | 40 124/109 002 | Study using Taiwanese health insurance data, including patient with diagnosis of hypertension (but not necessarily treated) | Exposed v not exposed | 0.66 (0.63 to 0.68)‡ | Lung: 0.57 (0.49 to 0.66); genitourinary system: 0.67 (0.59 to 0.76); breast: 0.66 (0.52 to 0.82); digestive system: 0.63 (0.58 to 0.69)‡ |
| Koomen, 200927 | 30/1318 cases; 148/6786 controls | Case control study with melanoma cases and matched controls, with Dutch drug and pathology databases | Exposed v not exposed | — | Melanoma: 1.1 (0.7 to 1.5)* |
| Fryzek, 200628 | 3053/49 950 | Database study with Danish registry data, including those with record of antihypertensive drug use | Exposed v not exposed | — | Breast: 1.01 (0.67 to 1.51)† |
| Fryzek, 200529 | 13 755/113 298 | Database study with Danish registry data, including those with record of antihypertensive drug use | Exposed v not exposed | — | Renal: 1.1 (0.6 to 2.2)† |
*Odds ratio.
†Rate ratio.
‡Hazard ratio.