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Hydrochlorothiazide and Non-Melanoma Skin Cancer in Asian Patients

By: Julia Fiederlein
Posted: Wednesday, October 7, 2020

In the United States and Europe, the diuretic hydrochlorothiazide is one of the most commonly prescribed antihypertensive drugs; however, this treatment has been suggested to increase skin cancer risk in White westerners. Hae-Young Lee, MD, of the Seoul National University Hospital, Korea, and colleagues conducted a study to investigate the potential association between treatment with hydrochlorothiazide and non-melanoma skin cancer in the Asian population. The results of this retrospective multicenter observational study were published in the Journal of Clinical Medicine.

“Although many findings in our study were inconclusive, there was a nonsignificant association of a dose-response pattern, with estimates increasing in cumulative dose of hydrochlorothiazide,” the investigators commented. “In particular, a trend with a nonsignificant positive association was observed with the high cumulative dose of hydrochlorothiazide.”

This analysis focused on 667,348 Korean patients who visited one of three study hospitals between 2004 and 2018. Those enrolled had a treatment history with hydrochlorothiazide, other antihypertensive drugs, or both. To evaluate the effects, Cox regression was performed by comparing the use of hydrochlorothiazide with other antihypertensive drugs. Subsequently, using propensity score matching, all analyses were re-evaluated with matched data. Results were combined with the meta-analysis to evaluate the overall effects.

A total of 1,162 cases of non-melanoma skin cancer were reported. Hydrochlorothiazide in combination with other hypertension diuretics seemed to be positively associated with the risk of non-melanoma skin cancer in the univariate analysis before propensity score matching (hazard ratio = 1.16; P = .89). In the group receiving hydrochlorothiazide alone or in combination with other hypertension diuretics, the low cumulative dose appeared to be negatively associated with the risk of non-melanoma skin cancer in the multivariate analysis before propensity score matching (adjusted hazard ratio = 0.69) as well as in univariate (adjusted hazard ratio = 0.72) and multivariate (adjusted hazard ratio = 0.70) analysis after propensity score matching.

Disclosure: The study authors reported no conflicts of interest.



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