Cancer risks among the users of ergot-derived dopamine agonists for Parkinson's disease, a nationwide population-based survey

Wang, Vinchi; Chao, Tzu-Hao; Hsieh, Chung-Chih; Lin, Chia-Hung; Kao, Chia‐Hung

doi:10.1016/j.parkreldis.2014.10.015

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…To date, there is only one epidemiological study, previously published, analyzing the pharmacological effect of DAs on the incidence of lung cancer. 19 The results from this study contradict those obtained in preclinical studies. However, the applicability and the interpretation of these results are limited by the small sample size analyzed, a crude analysis of the exposure to DAs (never vs. ever), and limited information about potential confounders.…”

Section: Introductioncontrasting

confidence: 86%

“…Clinical data regarding the effect of dopamine agonists (DAs) on NSCLC are scarce. To date, there is only one epidemiological study, previously published, analyzing the pharmacological effect of DAs on the incidence of lung cancer 19 . The results from this study contradict those obtained in preclinical studies.…”

Section: Introductioncontrasting

confidence: 76%

“…Our study is one of two population‐based studies assessing the association between DAs and lung cancer and the first to be conducted in a Western population. Wang et al 19 conducted a nested case–control study comparing “users” versus “non‐users” of DAs in a relatively small Taiwanese population (over 5000 patients diagnosed with PD), 49 of whom had a diagnosis of lung cancer. In their study, researchers found a non‐significant positive association between non‐ergot DAs and lung cancer (OR = 1.41; 95% CI 0.55–3.64), contradicting the findings from preclinical studies.…”

Section: Discussionmentioning

confidence: 99%

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Dopamine agonists and risk of lung cancer in patients with restless legs syndrome

Hernandez‐Con

Shults

Willis

et al. 2023

Pharmacoepidemiology and Drug

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Purpose To examine the association between long‐term use of dopamine agonists (DAs) and the risk of lung cancer in patients with restless legs syndrome (RLS). Methods We conducted a retrospective cohort study using Optum Clinformatics® database. We included adults ≥40 years diagnosed with RLS during the study period (1/2006–12/2016). Follow‐up started with the first RLS diagnosis and ended on the earliest of: incident diagnosis of lung cancer, end of enrollment in the database or end of the study period. The exposure of interest was cumulative duration of DAs use, measured in a time‐varying manner. We constructed a multivariable Cox regression model to estimate HRs and 95% CIs for the association between lung cancer and cumulative durations of DA use, adjusting for potential confounding variables. Results We identified 295 042 patients with a diagnosis of RLS. The mean age of the cohort was 62.9; 66.6% were women and 82.3% were white. The prevalence of any DA exposure was 40.3%. Compared to the reference group (no use and ≤1 year), the crude HRs for lung cancer were 1.16 (95% CI 0.99–1.36) and 1.14 (95% CI 0.86–1.51) for 1–3 years and >3 years of cumulative DA use, respectively. The adjusted HR for lung cancer was 1.05 (95% CI 0.88–1.25) for 1–3 years and 1.02 (95% CI 0.76–1.37) for >3 years of cumulative DA use, respectively. Conclusions At typical doses for the clinical management of RLS, long‐term DA use was not associated with risk of lung cancer.

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Section: Introductioncontrasting

confidence: 86%

Section: Introductioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Dopamine agonists and risk of lung cancer in patients with restless legs syndrome

Hernandez‐Con

Shults

Willis

et al. 2023

Pharmacoepidemiology and Drug

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“…However, similar to other neuropsychiatric disorders, such as Alzheimer’s disease and schizophrenia, and some non-neurological diseases (5) epidemiological studies described an intriguing inverse comorbidity between Parkinson’s disease and cancer, mainly colorectal, lung, prostate and bladder cancers (4, 6–15) although some studies showed inconclusive results (16–18). Potential mechanisms explaining this association include: common genetic predispositions that are activated in opposite directions in neuronal compared to proliferating tissue (such as PIN1 and LRRK2) (19, 20); aberrations in the ubiquitin-proteasome system (21,22); low levels of melatonin that can improve Parkinson’s symptoms and appears to increase cancer risk (23); smoking status, a known cancer risk factor that was shown to reduce risk for Parkinson’s disease (24,25); diabetes (24) and high levels of cholesterol and fatty acids (26) that were described in association with lower risk for Parkinson’s disease; cancer promoting effect of anti-Parkinsonian medications, such as dopamine agonists (27); survival bias due to early mortality in patients with Parkinson’s disease; and detection bias secondary to different cancer screening practices among patients with neurodegenerative disorders due to disease severity or socioeconomic status.…”

Section: Introductionmentioning

confidence: 99%

Parkinson’s disease and colorectal cancer risk—A nested case control study

Boursi

Mamtani

Haynes

et al. 2016

Cancer Epidemiology

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Background A pro-inflammatory gut microbiota was described in both Parkinson’s disease and colorectal cancer (CRC) and recently α-synuclein was demonstrated in the enteric nervous system. We sought to evaluate the association between Parkinson’s disease and CRC. Methods We conducted a nested case-control study using a large primary-care database. Cases were defined as all individuals with CRC. Up to 4 controls were matched with each case based on age, sex, practice-site and duration of follow-up. The primary exposure of interest was diagnosis of Parkinson’s disease prior to CRC as well as disease duration, and Parkinson’s specific therapies. The primary analysis was a conditional logistic-regression to estimate odds ratios (ORs) and 95% confidence interval (95%CI). Results The study included 22,093 CRC cases and 85,833 matched controls. Past medical history of Parkinson’s disease >1 year before index-date was associated with lower CRC risk (OR 0.74, 95%CI 0.59–0.94). The inverse association was more prominent among females compared to males (0.64, 95%CI 0.42–0.96 and 0.8, 95%CI 0.60–1.07, respectively). While patients who received no therapy or therapy with dopamine agonists had a non-significant decrease in cancer risk, patients who were treated with dopamine had a non-significant elevated cancer risk. Conclusion Parkinson’s disease is inversely associated with CRC risk.

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“…Of the studies identified through the initial database search, eight investigated the effect of pharmaceutical PD treatment on cancer risk [17,[53][54][55][56][57][58][59], five looked at the impact of genetic variants, such as LRRK2 on cancer development [13,[16][17][18]60] and six investigated PD's effect on the development of specific cancers [3,22,56,58,61,62]. Another study [63] investigated PD's impact on subsequent cancer development but did not report the outcome statistics, and was excluded from primary analysis.…”

Section: Eligibility Criteriamentioning

confidence: 99%

Parkinson’s disease and cancer: a systematic review and meta-analysis on the influence of lifestyle habits, genetic variants, and gender

Lee

Saffari

et al. 2022

Aging

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Purpose: The relationship between Parkinson’s disease (PD) and cancer has been debated. Gender and genetic influences on cancer development in PD is unclear. Methods: Using QUOROM guidelines, we conducted a systematic review and meta-analysis on potential clinical and genetic factors influencing the PD and subsequent cancer relationship. English articles published in PubMed, Web of Science, and SCOPUS from 2010 to 30 August 2020 were considered for suitability. Results: Of 46 studies identified, fourteen satisfied the inclusion criteria and were further analysed. Unadjusted risk ratios (RR) and 95% confidence intervals were computed to determine the PD and cancer relationship. PD patients have decreased subsequent cancer risks (RR = 0.87, 95% CI = 0.81–0.93), reduced risks of colon, rectal, and colorectal cancer (RR = 0.77, 95% CI = 0.63–0.94), lung cancer (RR = 0.62, 95% CI = 0.48–0.80), and increased brain cancer (R = 1.48, 95% CI = 1.02–2.13) and melanoma risk (R = 1.76, 95% CI = 1.23–2.50). Compared to idiopathic PD, LRRK2-G2019S carriers had increased general cancer risks (RR = 1.26, 95% CI = 1.09–1.46), particularly brain (RR = 2.41, 95% CI = 1.06–5.50), breast (RR = 2.57, 95% CI = 1.19–5.58), colon (RR = 1.83, 95% CI = 1.13–2.99), and haematological cancers (RR = 2.05, 95% CI = 1.07–3.92). Female PD patients have decreased general cancer risks compared to male PD patients in this analysis (RR = 0.83, 95% CI = 0.69–0.98). Conclusion: PD patients have reduced risks of colon, rectal, colorectal cancer and lung cancers and increased risks of brain cancer and melanoma. LRRK2-G2019S carriers have increased cancer risks, particularly brain, breast, colon and blood cancers. Female gender was associated with reduced risks. The role of ethnicity, comorbidities, and lifestyle habits on PD patients’ subsequent cancer risk should be further investigated.

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Cancer risks among the users of ergot-derived dopamine agonists for Parkinson's disease, a nationwide population-based survey

Cited by 10 publications

References 30 publications

Dopamine agonists and risk of lung cancer in patients with restless legs syndrome

Dopamine agonists and risk of lung cancer in patients with restless legs syndrome

Parkinson’s disease and colorectal cancer risk—A nested case control study

Parkinson’s disease and cancer: a systematic review and meta-analysis on the influence of lifestyle habits, genetic variants, and gender

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