Impact of Hydrochlorothiazide on Nonmelanoma Skin Cancer: A Distributed Network Analysis of 11 Real-world Databases
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Background: Hydrochlorothiazide (HCTZ) has carcinogenic effects owing to its photosensi- tizing properties. Recent studies have reported inconsistent results regarding the association between HCTZ and skin cancer. Objective: This study aimed to clarify the effects of HCTZ on the risk of developing nonmela- noma skin cancer (NMSC) in Korean patients with hypertension. Methods: This multicenter, retrospective cohort study was conducted using clinical data from 11 hospitals in Korea, and converted to the Observational Medical Outcomes Partnership-Common Data Model. Large-scale 1:1 propensity score-matching was conducted to balance the target and comparator cohorts. Cox regression analysis was used to examine the hazard ratio (HR) for NMSC in HCTZ users compared to HCTZ never-users. Results: 8,821 patients and same number of controls were pooled from 11 databases. HCTZ use was not associated with a decreased risk of NMSC (HR, 1.01; 95% confidence interval [CI], 0.70–1.47). In the dose-response analysis, no significant correlation was found between NMSC risk and HCTZ dose for <1 year (HR, 1.17; 95% CI, 0.64–2.17) and ≥1 year (HR, 1.02; 95% CI, 0.64–1.61). No significant increase in the risk of NMSC was observed in the subgroup analyses for either age or sex. Conclusion: HCTZ was not associated with the development of NMSC in a Korean hypertensive population, regardless of the duration of drug exposure.
Abstract
Background: Hydrochlorothiazide (HCTZ) has carcinogenic effects owing to its photosensi- tizing properties. Recent studies have reported inconsistent results regarding the association between HCTZ and skin cancer. Objective: This study aimed to clarify the effects of HCTZ on the risk of developing nonmela- noma skin cancer (NMSC) in Korean patients with hypertension. Methods: This multicenter, retrospective cohort study was conducted using clinical data from 11 hospitals in Korea, and converted to the Observational Medical Outcomes Partnership-Common Data Model. Large-scale 1:1 propensity score-matching was conducted to balance the target and comparator cohorts. Cox regression analysis was used to examine the hazard ratio (HR) for NMSC in HCTZ users compared to HCTZ never-users. Results: 8,821 patients and same number of controls were pooled from 11 databases. HCTZ use was not associated with a decreased risk of NMSC (HR, 1.01; 95% confidence interval [CI], 0.70–1.47). In the dose-response analysis, no significant correlation was found between NMSC risk and HCTZ dose for <1 year (HR, 1.17; 95% CI, 0.64–2.17) and ≥1 year (HR, 1.02; 95% CI, 0.64–1.61). No significant increase in the risk of NMSC was observed in the subgroup analyses for either age or sex. Conclusion: HCTZ was not associated with the development of NMSC in a Korean hypertensive population, regardless of the duration of drug exposure.