Journal article
Angiotensin blockade therapy and survival in pancreatic cancer: a population study
BMC cancer, v 22(1), 150
07 Feb 2022
PMID: 35130875
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Pancreatic cancer (PC) is one of the most aggressive and challenging cancer types to effectively treat, ranking as the fourth-leading cause of cancer death in the United States. We investigated if exposures to angiotensin II receptor blockers (ARBs) or angiotensin I converting enzyme (ACE) inhibitors after PC diagnosis are associated with survival.
PC patients were identified by ICD-9 diagnosis and procedure codes among the 3.7 million adults living in the Emilia-Romagna Region from their administrative health care database containing patient data on demographics, hospital discharges, all-cause mortality, and outpatient pharmacy prescriptions. Cox modeling estimated covariate-adjusted mortality hazard ratios for time-dependent ARB and ACE inhibitor exposures after PC diagnosis.
8,158 incident PC patients were identified between 2003 and 2011, among whom 20% had pancreas resection surgery, 36% were diagnosed with metastatic disease, and 7,027 (86%) died by December 2012. Compared to otherwise similar patients, those exposed to ARBs after PC diagnosis experienced 20% lower mortality risk (HR=0.80; 95% CI: 0.72, 0.89). Those exposed to ACE inhibitors during the first three years of survival after PC diagnosis experienced 13% lower mortality risk (HR=0.87; 95% CI: 0.80, 0.94) which attenuated after surviving three years (HR=1.14; 95% CI: 0.90, 1.45).
The results of this large population study suggest that exposures to ARBs and ACE inhibitors after PC diagnosis are significantly associated with improved survival. ARBs and ACE inhibitors could be important considerations for treating PC patients, particularly those with the worst prognosis and most limited treatment options. Considering that these common FDA approved drugs are inexpensive to payers and present minimal increased risk of adverse events to patients, there is an urgent need for randomized clinical trials, large simple randomized trials, or pragmatic clinical trials to formally and broadly evaluate the effects of ARBs and ACE inhibitors on survival in PC patients.
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Details
- Title
- Angiotensin blockade therapy and survival in pancreatic cancer: a population study
- Creators
- Scott W Keith - Thomas Jefferson UniversityVittorio Maio - Thomas Jefferson UniversityHwyda A Arafat - University of New EnglandMatthew Alcusky - University of Massachusetts Chan Medical SchoolThomas Karagiannis - Thomas Jefferson UniversityCarol Rabinowitz - Thomas Jefferson UniversityHarish Lavu - Thomas Jefferson UniversityDaniel Z Louis - Thomas Jefferson University
- Publication Details
- BMC cancer, v 22(1), 150
- Publisher
- Springer Nature
- Grant note
- IRG-08-060-04 / American Cancer Society
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000752391100001
- Scopus ID
- 2-s2.0-85124290495
- Other Identifier
- 991022047144904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology