Long-Term Risk of Skin Cancer and Lymphoma in Users of Topical Tacrolimus and Pimecrolimus: Final Results from the Extension of the Cohort Study Protopic Joint European Longitudinal Lymphoma and Skin Cancer Evaluation (JOELLE).
Abstract | PURPOSE: PATIENTS AND METHODS: RESULTS: The study included 126,908/61,841 adults and 32,605/27,961 children initiating treatment with tacrolimus/ pimecrolimus, respectively. Follow-up was ≥10 years for 19% of adults and 32% of children. Incidence rate ratios and (95% confidence intervals) for tacrolimus versus corticosteroid users in adults were <1 for melanoma, non-Hodgkin lymphoma, and Hodgkin lymphoma; and 1.80 (1.25-2.58) for cutaneous T-cell lymphoma. For pimecrolimus, IRRs in adults were <1 for non-Hodgkin lymphoma, cutaneous T-cell lymphoma, and Hodgkin's lymphoma; and 1.21 (1.03-1.41) for melanoma; and 1.28 (1.20-1.35) for nonmelanoma skin cancer. In children, results were inconclusive due to few events. In adults, incidence rate ratios ≥5 years after first topical calcineurin inhibitor exposure were not higher than in overall analyses. CONCLUSION: Overall, we found little evidence associating use of topical calcineurin inhibitors with skin cancer and lymphoma; confounding by indication, surveillance bias, and reverse causation may have influenced these results. Even if causal, the public health impact of these excess risks would be low and confined to the first years of exposure.
|
Authors | Alejandro Arana, Anton Pottegård, Josephina G Kuiper, Helen Booth, Johan Reutfors, Brian Calingaert, Lars Christian Lund, Elizabeth Crellin, Marcus Schmitt-Egenolf, James A Kaye, Karin Gembert, Kenneth J Rothman, Helle Kieler, Daniel Dedman, Eline Houben, Lia Gutiérrez, Jesper Hallas, Susana Perez-Gutthann |
Journal | Clinical epidemiology
(Clin Epidemiol)
Vol. 13
Pg. 1141-1153
( 2021)
ISSN: 1179-1349 [Print] New Zealand |
PMID | 35002327
(Publication Type: Journal Article)
|
Copyright | © 2021 Arana et al. |
|
Join CureHunter, for free Research Interface BASIC access!
Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease.
Find out why thousands of doctors, pharma researchers and patient activists
around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!
|