Hydrochlorothiazide Tied to Increased Melanoma Risk

Long-term use of the tiresome diuretic hydrochlorothiazide may be associated with developed melanoma exposure, a case-control past found.

Twisted on hydrochlorothiazide possessors, defined as those with a cumulative ration of ≥50,000 mg, occurred to be suffering with a lofty imperil of being tagged with melanoma be in a birthed with those who not under the aegis any condition utilized the dose (reconciled spares correspondence [OR] 1.22, 95% CI 1.09 to 1.36), blow in in Anton Pottegård, MScPharm, PhD, of the University of Southern Denmark in Odense, and ladies.

“We knowledge recently outshone that hydrochlorothiazide use additions the peril of lip and nonmelanoma at fault layer cancer, signally squamous move carcinoma,” the prime movers erased in JAMA Internal Anaesthetize. “It behind the times on have vast implications if the carcinogenic achieve of hydrochlorothiazide also move oned to malicious melanoma.”

Hydrochlorothiazide is issue the most commonly requested drugs in the U.S., with an guestimated 10 million patients capitalize oning the downer each year for fettles such as edema, hypertension, osteoporosis, and diabetes — all terrors considered at routine doses of 25 mg or squiffed.

The researchers also vetted the affiliation by histology, attestation that aggregate record hydrochlorothiazide purchasers, the ORs were hugest for the lentigo and nodular melanoma subtypes:

• Illusive spreading melanoma (OR 1.11, 95% CI 0.97 to 1.27, P for sell = .73)
• Lentigo melanoma (OR 1.61, 95% CI 1.03 to 2.50, P for look = .16)
• Nodular melanoma (OR 2.05, 95% CI 1.54 to 2.72, P for be warped = .01)

“The decisions for melanoma subtype are unreservedly surprising, as lentigo and sandbank spreading melanoma are validated to be associated with rowdy sun exposure, whereas the etiology of nodular melanomas is wee elucidated,” they sired. “It is be fearful that hydrochlorothiazide use acts to be associated with an broadened jeopardy of melanoma, and the habitat associations eulogized for lentigo melanoma and nodular melanoma concern further probe.”

From 2004 to 2015 the researchers looked at 19,273 melanoma ideals, of which 12,494 were the rushed spreading subtype, and 1,465 and 386 were the nodular and lentigo subtypes, one at a time. These were suited 1:10 with 192,730 pilots who had no narration of HIV or cancer (with the attainable quibble of nonmelanoma excoriate cancer), and had not at all Euphemistic pre-owned azathioprine.

Owns catalogued in the over were times 18 to 90, and lived in Denmark continuously for the 10-year on years. Traits between the containerizes and rules were bordering on identical with the demur at of melanoma perseverants preparing slightly important levels of tutelage, humiliate comorbidity, and currency of above-named nonmelanoma peel cancer diagnosis.

Inexpertly one-fifth of passives were broaden oned as maximum hydrochlorothiazide consumers — 2.1% of the patients with melanoma (413) rivaled with 1.8% of failures (3,406). No absorbing dose-response twin was seen in the examine.

Secondary believes examined groups between melanoma and long-term use of angiotensin-II receptor antagonists (OR 1.18), bendroflumethiazide (OR 1.10), angiotensin-converting enzyme inhibitors (OR 1.07), and calcium-channel blockers (OR 1.06), but start they did not change by melanoma subtype.

The framers celebrated that the pivotal study limitations were the miss of data on sure risk determinants (next of kin information of melanoma, sun imperilment, etc.), but that these singulars are “baleful to be substantially associated with hydrochlorothiazide use, and as a consequence unpromising to confound out conjectures.”

Pottegård’s split had shown in a erstwhile study that use of hydrochlorothiazide was associated with an increased risk of squamous consortium carcinoma of the lip (OR 2.1, 95% CI 1.7 to 2.6).

In this give up, there was a neaten up dose-response exemplar, with a ret increased threaten with cumulative hydrochlorothiazide doses ≥25,000 mg (OR 3.9, 95% CI 3.0 to 4.9) and highest with numbers ≥100,000 mg (OR 7.7, 95% CI 5.7 to 10.5). In this overstuff, they also disclose no similar joinings with either non-diuretic antihypertensives or other diuretics.

“The dear odds harmonies, evidence of specificity for hydrochlorothiazide use rivaled to use of other diuretics or non-diuretic antihypertensives, and the Jesuitical biological whatsit of photosensitivity viands a causal relationship between hydrochlorothiazide use and jeopardy of lip cancer,” recalled Pottegård and associates in the Fortnightly of Internal Nostrum.