Angiotensin Receptor Blockers and the Risk of Cancer: Insights from Clinical Trials and Recent Drug Recalls

Berrido, Andrea M; Byrd, James Brian

doi:10.1007/s11906-020-1021-0

Cited by 12 publications

(6 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two recent trends also affect utilization of cardiovascular drugs: nearly ubiquitous reliance on generic drug products and increased use of manufacturing facilities in China and India [27]. The most common reason for product recalls is manufacturing issues.…”

Section: Discussionmentioning

confidence: 99%

Impact of angiotensin receptor blocker product recalls on antihypertensive prescribing in Germany

Rudolph

Enners²,

Kieble³

et al. 2020

J Hum Hypertens

View full text Add to dashboard Cite

In Germany, ~8 million patients take angiotensin receptor blockers (ARBs) and 2.25 million of them valsartan. In 2018, contamination of generic ARBs with probable carcinogenic nitrosamines resulted in more than 30 recalls. The impact of such a huge recall has never been explored in Europe. We analyzed the utilization of valsartan, all ARBs, and other alternative antihypertensive drugs in Germany. We used our database of anonymized dispensing data from >80% of community pharmacies at the expense of the statutory health insurance (SHI) funds from January 2017 to December 2019. We analyzed 290.8 million prescriptions, including all oral mono- and fixed-dose combinations of ARBs and plausible alternatives, i.e. ACE inhibitors (ACEi), beta-blockers (BB), and calcium channel blockers (CCB). Utilization was calculated by defined daily doses per 1000 SHI-insured persons per day (DID). Valsartan use decreased substantially after the recalls in July 2018 from 39.0 to 14.2 DID (−64%) in the second quarter of 2019 and to 16.9 DID (−57%) in the fourth quarter of 2019. Simultaneously, the use of alternative ARBs increased from 77.7 DID in the second quarter of 2018 to 121.9 DID (+57%) in the fourth quarter of 2019, mainly due to an increase of candesartan dispensing to 99.8 DID (+73%). There were no changes in the utilization of ACEi, BB, or CCB. The majority of recalled generic valsartan products were replaced by other ARBs, predominantly candesartan, despite documented drug shortages. In contrast to previous safety warnings/recalls, our data do not suggest an under-prescription of antihypertensives during this period.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of angiotensin receptor blocker product recalls on antihypertensive prescribing in Germany

Rudolph

Enners²,

Kieble³

et al. 2020

J Hum Hypertens

View full text Add to dashboard Cite

show abstract

“…However, more research is needed to examine the correlation between Fe concentrations in the blood and lungs with cancer incidence in smokers treated with ARBs. Recent studies on the influence of ARBs on lung cancer risk are conflicting, with some reporting an increased risk, some revealing no influence, and others reporting a protective action [ 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Some potential pro-carcinogenic actions of ARBs may stem from drug impurities [ 55 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

“…Recent studies on the influence of ARBs on lung cancer risk are conflicting, with some reporting an increased risk, some revealing no influence, and others reporting a protective action [ 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Some potential pro-carcinogenic actions of ARBs may stem from drug impurities [ 55 , 56 ]. However, they may increase the risk of cancer only in specific circumstances, such as tobacco smoking.…”

Section: Resultsmentioning

confidence: 99%

Concentrations of Transition Metal Ions in Rat Lungs after Tobacco Smoke Exposure and Treatment with His-Leu Dipeptide

et al. 2023

View full text Add to dashboard Cite

Tobacco smoking is deleterious to the lungs because it exposes them to many toxic substances. These include transition metal ions, such as cadmium. However, there is a lack of information about the influence of endogenous metal-binding peptides, such as His-Leu (HL), on the lung distribution of transition metals in smokers. To address this, we administered HL subcutaneously to rats exposed to tobacco smoke for six weeks, then we measured the concentrations of transition metal ions in the lungs. We found that exposure to tobacco smoke elevates the concentrations of Cd(II) and Cu(II). Administration of the HL peptide, whose elevation is a consequence of angiotensin receptor blocker anti-hypertension therapy, increases the concentration of Fe in the lungs of rats exposed to smoke. These findings suggest that smoking is a risk factor for patients receiving angiotensin receptor blockers to treat hypertension.

show abstract

“…Therefore, long-term follow-up of a large cohort of patients exposed to the contaminants is essential to evaluate such risk. Concurrently with follow-up studies and product recalls, 3,39 testing for and eliminating contaminants in the manufacturing process is also needed to ensure patients' safety.…”

Section: Discussionmentioning

confidence: 99%

Cancer Risk of Angiotensin II Receptor Blocker Valsartan: A Population-based Study

Chan

Tsoi

Cheung

2022

Journal of Cardiovascular Pharmacology

View full text Add to dashboard Cite

show abstract

Angiotensin Receptor Blockers and the Risk of Cancer: Insights from Clinical Trials and Recent Drug Recalls

Cited by 12 publications

References 22 publications

Impact of angiotensin receptor blocker product recalls on antihypertensive prescribing in Germany

Impact of angiotensin receptor blocker product recalls on antihypertensive prescribing in Germany

Concentrations of Transition Metal Ions in Rat Lungs after Tobacco Smoke Exposure and Treatment with His-Leu Dipeptide

Cancer Risk of Angiotensin II Receptor Blocker Valsartan: A Population-based Study

Contact Info

Product

Resources

About