Oral Bisphosphonate and Risk of Esophageal Cancer: A Nationwide Claim Study
0
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background: Epidemiology studies suggest that oral bisphosphonate may increase the risk of esophageal cancer. The present study aimed to investigate the association between exposure of oral bisphosphonate and risk of esophageal cancer. Methods: Using the nationwide medical claim database in South Korea, 2,167,955 subjects, who initiated osteoporosis treatment (oral bisphosphonate, intravenous bisphosphonate or raloxifene) or performed dual energy X-ray absorptiometry (DXA) between 2008 and 2012, were analyzed. Diagnosis of esophageal cancer was estimated from medical claim database. Standardized incidence ratio (SIR) was estimated by comparing with incidence in the general population. Cox proportional hazards modeling was used to investigate age-adjusted hazard ratio (aHR) of esophageal cancer. Results: The present study included oral bisphosphonate group (N=1,435,846), comparator group 1 (intravenous bisphosphonate or raloxifene, N=78,363) and comparator group 2 (DXA, N=653,746). Mean age was 65.6±8.8 years and mean observation duration was 30.9±17.7 months. During 5,503,688 patient-years, 205 esophageal cancer incidences were observed. The annual incidence of esophageal cancer was 3.88, 4.21 and 3.30 for oral bisphosphonate group, comparator group 1 and comparator group 2, respectively. SIR of esophageal cancer was 1.24, 1.38 and 1.40 for oral bisphosphonate group, comparator group 1 and comparator group 2, respectively. Esophageal cancer risk of oral bisphosphonate group was not significantly different from comparator group 1 and comparator group 2 (aHR 0.87; 95% confidence interval [CI] 0.39-1.98 and aHR 0.94; 95% CI 0.68-1.30, respectively). Conclusions: The use of oral bisphosphonate was not associated with increased risk of esophageal cancer in real clinical practice using large scale nationwide database.
Abstract
Background: Epidemiology studies suggest that oral bisphosphonate may increase the risk of esophageal cancer. The present study aimed to investigate the association between exposure of oral bisphosphonate and risk of esophageal cancer. Methods: Using the nationwide medical claim database in South Korea, 2,167,955 subjects, who initiated osteoporosis treatment (oral bisphosphonate, intravenous bisphosphonate or raloxifene) or performed dual energy X-ray absorptiometry (DXA) between 2008 and 2012, were analyzed. Diagnosis of esophageal cancer was estimated from medical claim database. Standardized incidence ratio (SIR) was estimated by comparing with incidence in the general population. Cox proportional hazards modeling was used to investigate age-adjusted hazard ratio (aHR) of esophageal cancer. Results: The present study included oral bisphosphonate group (N=1,435,846), comparator group 1 (intravenous bisphosphonate or raloxifene, N=78,363) and comparator group 2 (DXA, N=653,746). Mean age was 65.6±8.8 years and mean observation duration was 30.9±17.7 months. During 5,503,688 patient-years, 205 esophageal cancer incidences were observed. The annual incidence of esophageal cancer was 3.88, 4.21 and 3.30 for oral bisphosphonate group, comparator group 1 and comparator group 2, respectively. SIR of esophageal cancer was 1.24, 1.38 and 1.40 for oral bisphosphonate group, comparator group 1 and comparator group 2, respectively. Esophageal cancer risk of oral bisphosphonate group was not significantly different from comparator group 1 and comparator group 2 (aHR 0.87; 95% confidence interval [CI] 0.39-1.98 and aHR 0.94; 95% CI 0.68-1.30, respectively). Conclusions: The use of oral bisphosphonate was not associated with increased risk of esophageal cancer in real clinical practice using large scale nationwide database.
참고문헌 (21)
- Shin CS, "Prevalence and risk factors of osteoporosis in Korea : a community-based cohort study with lumbar spine and hip bone mineral density", Bone, 47, pp.378~387 (2010)
- Shin CS, "The prevalence and risk factors of vertebral fractures in Korea", J Bone Miner Metab, 30, pp.183~192 (2012)
- Lee YK, "Bisphosphonate use and subsequent hip fracture in South Korea", Osteoporos Int, 24, pp.2887~2892 (2013)
- Chung DJ, "The prevalence and risk factors of vertebral fractures in Korean patients with type 2 diabetes", J Bone Miner Metab, 31, pp.161~168 (2013)
- Wysowski DK, "Reports of esophageal cancer with oral bisphosphonate use", N Engl J Med, 360, pp.89~90 (2009)
- Green J, "Oral bisphosphonates and risk of cancer of oesophagus, stomach, and colorectum: case-control analysis within a UK primary care cohort", BMJ, 341, pp.c4444~ (2010)
- Cardwell CR, "Exposure to oral bisphosphonates and risk of esophageal cancer", JAMA, 304, pp.657~663 (2010)
- Vinogradova Y, "Exposure to bisphosphonates and risk of gastrointestinal cancers: series of nested case-control studies with QResearch and CPRD data", BMJ, 346, pp.f114~ (2013)
- 김상환, "National Utilization of Calcium Supplements in Patients with Osteoporotic Hip Fracture in Korea", 대한골대사학회지, 20(2), pp.99~103 (2013), 대한골대사학회
- 서기현, "Risk of Hip Fractures in Men with Alpha-Blockers: A Nationwide Study Base on Claim Registry", 대한골대사학회지, 22(1), pp.29~32 (2015), 대한골대사학회[DOI]
- 박찬미, "Incidence and Mortality after Proximal Humerus Fractures Over 50 Years of Age in South Korea: National Claim Data from 2008 to 2012", 대한골대사학회지, 22(1), pp.17~21 (2015), 대한골대사학회[DOI]
- Choi HJ, "Risk of fractures in subjects with antihypertensive medications : A nationwide claim study", Int J Cardiol, 184, pp.62~67 (2015)
- Choi HJ, "Burden of osteoporosis in adults in Korea: a national health insurance database study", J Bone Miner Metab, 30, pp.54~58 (2012)
- 하용찬, "Physicians’ Attitudes to Contemporary Issues on Osteoporosis Management in Korea", 대한골대사학회지, 21(2), pp.139~145 (2014), 대한골대사학회
- 공성열, "Effects of a ‘Drug Holiday’ on Bone Mineral Density and Bone Turnover Marker During Bisphosphonate Therapy", 대한골대사학회지, 20(1), pp.31~35 (2013), 대한골대사학회[DOI]
- Wright E, "Bisphosphonates and risk of upper gastrointestinal cancer--a case control study using the General Practice Research Database (GPRD)", PLoS One, 7, pp.e47616~ (2012)
- Vestergaard P, "Occurrence of gastrointestinal cancer in users of bisphosphonates and other antiresorptive drugs against osteoporosis", Calcif Tissue Int, 89, pp.434~441 (2011)
- Sun K, "Bisphosphonate treatment and risk of esophageal cancer : a meta-analysis of observational studies", Osteoporos Int, 24, pp.279~286 (2013)
- Oh YH, "Bisphosphonate use and gastrointestinal tract cancer risk : meta-analysis of observational studies", World J Gastroenterol, 18, pp.5779~5788 (2012)
- Ho YF, "Oral bisphosphonates and risk of esophageal cancer : a dose-intensity analysis in a nationwide population", Cancer Epidemiol Biomarkers Prev 2012 ;, 21, pp.993~995 (2012)
- Lee WY, "A higher dosage of oral alendronate will increase the subsequent cancer risk of osteoporosis patients in Taiwan: a population-based cohort study", PLoS One, 7, pp.e53032~ (2012)