Hydrochlorothiazide use is associated with the risk of cutaneous and lip squamous cell carcinoma: A systematic review and meta-analysis

Andrade, Ana Cláudia de; Felix, Fernanda Aragão; França, Glória Maria de; Ribeiro, Isabella Lima Arrais; Barboza, Carlos Augusto Galvão; Costa, Antônio de Lisboa Lopes

doi:10.1007/s00228-022-03299-x

Cited by 11 publications

(5 citation statements)

References 34 publications

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“…These results are in line with recent studies that demonstrated an association of HCTZ and UV-induced skin cancer. 29,[31][32][33][34][35]39 An Icelandic retrospective study included 6880 patients diagnosed with first-time BCC or SCC/SCCin-situ and revealed an increased risk of SCC development (OR 1.69), SCC-in-situ (OR, 1.24) and BCC (OR, 1.14) with high cumulative doses of HCTZ. 29 Besides SCC/BCC, several reports demonstrated that the use of HCTZ was linked to…”

Section: Discussionmentioning

confidence: 99%

“…27,28 In recent years, several large case-control and cohort studies evaluated the risk of skin cancer (SCC/SCC-in-situ and BCC) in association with long-term use of HCTZ. [29][30][31][32][33][34][35] Furthermore, the use of HCTZ was associated with an increased risk of other UV-induced skin tumors like malignant melanoma (MM). 35,36 Subsequently, recent meta analyses confirmed the enhanced risk of NMSC and MM with the use of HCTZ.…”

Section: Introductionmentioning

confidence: 99%

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Hydrochlorothiazide and increased risk of atypical fibroxanthoma and pleomorphic dermal sarcoma

Kuntz,

Grimm,

Hofmann

et al. 2024

J Deutsche Derma Gesell

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SummaryBackground and ObjectivesPrevious work has demonstrated that hydrochlorothiazide (HCTZ) is a risk factor for squamous cell carcinomas (SCC) and basal cell carcinomas (BCC) due to pro‐photocarcinogenic effects. Atypical fibroxanthoma (AFX) and pleomorphic sarcoma (PDS), both ultraviolet‐induced cancers, display a rare but rising cutaneous tumor entity. This study aimed to evaluate if the use of HCTZ is higher in patients with AFX/PDS than in patients with SCC/BCC and subsequently may be a risk factor for AFX/PDS‐development.Patients and MethodsIn a retrospective study of four German skin cancer centers, AFX/PDS cases and SCC/BCC controls were sex and age matched (1:3) over a time‐period of 7 years (2013–2019) to evaluate the use of HCTZ, immunosuppressive medication, second malignancies, and presence of diabetes mellitus.ResultsOverall, 146 AFX/PDS and 438 controls (SCC/BCC) were included in the study. The use of HCTZ was significantly higher in patients with AFX/PDS (44.5%) compared to patients with SCC/BCC (25.3%). Additionally, the presence of diabetes mellitus was significantly higher in AFX/PDS patients.ConclusionsThis study demonstrates a significantly higher use of HCTZ in patients with AFX/PDS compared to SCC/BCC. This result suggests that HCTZ may be a risk factor for AFX/PDS. Additionally, diabetes mellitus or its comorbidities may be associated with an increased risk for AFX/PDS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hydrochlorothiazide and increased risk of atypical fibroxanthoma and pleomorphic dermal sarcoma

Kuntz,

Grimm,

Hofmann

et al. 2024

J Deutsche Derma Gesell

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“…Given these safety precautions, the starting dose of 25 mg and down-titrating when clinically necessary, instead of an up-titration schedule, is justified. In addition to the risk of electrolyte imbalances, long-term HCT treatment can induce gout, and some studies have also reported an increased incidence of nonmelanoma skin cancer [ 27 , 28 ]. For that reason, a medical history of active gouty arthritis despite preventive treatment for gout and any form of skin cancer were added as exclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

HYDROchlorothiazide versus placebo to PROTECT polycystic kidney disease patients and improve their quality of life: study protocol and rationale for the HYDRO-PROTECT randomized controlled trial

Bais,

Meijer,

Kramers

et al. 2024

Trials

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Background Autosomal dominant polycystic kidney disease (ADPKD) leads to progressive renal cyst formation and loss of kidney function in most patients. Vasopressin 2 receptor antagonists (V2RA) like tolvaptan are currently the only available renoprotective agents for rapidly progressive ADPKD. However, aquaretic side effects substantially limit their tolerability and therapeutic potential. In a preliminary clinical study, the addition of hydrochlorothiazide (HCT) to tolvaptan decreased 24-h urinary volume and appeared to increase renoprotective efficacy. The HYDRO-PROTECT study will investigate the long-term effect of co-treatment with HCT on tolvaptan efficacy (rate of kidney function decline) and tolerability (aquaresis and quality of life) in patients with ADPKD. Methods The HYDRO-PROTECT study is an investigator-initiated, multicenter, double-blind, placebo-controlled, randomized clinical trial. The study is powered to enroll 300 rapidly progressive patients with ADPKD aged ≥ 18 years, with an eGFR of > 25 mL/min/1.73 m2, and on stable treatment with the highest tolerated dose of tolvaptan in routine clinical care. Patients will be randomly assigned (1:1) to daily oral HCT 25 mg or matching placebo treatment for 156 weeks, in addition to standard care. Outcomes The primary study outcome is the rate of kidney function decline (expressed as eGFR slope, in mL/min/1.73 m2 per year) in HCT versus placebo-treated patients, calculated by linear mixed model analysis using all available creatinine values from week 12 until the end of treatment. Secondary outcomes include changes in quality-of-life questionnaire scores (TIPS, ADPKD-UIS, EQ-5D-5L, SF-12) and changes in 24-h urine volume. Conclusion The HYDRO-PROTECT study will demonstrate whether co-treatment with HCT can improve the renoprotective efficacy and tolerability of tolvaptan in patients with ADPKD.

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“…Die vorliegenden Ergebnisse stehen im Einklang mit kürzlich veröffentlichten Studien, die einen Zusammenhang zwischen HCT und UV-induziertem Hautkrebs beschreiben. 29,[31][32][33][34][35]39 Eine retrospektive Studie aus Island mit 6880 Patienten mit der Erstdiagnose eines BCC oder SCC/SCC-in-situ zeigte ein erhöhtes Risiko für die Entwicklung eines SCC (OR 1,69), SCC-in-situ (OR, 1,24) oder BCC (OR, 1,14) bei hohen kumulativen HCT-Dosen. 29 Neben SCC/BCC wurde in mehreren Studien auch ein Zusammenhang zwischen der Einnahme von HCT und anderen UV-induzierten Hauttumoren, zum Beispiel MCC und MM, beschrieben.…”

Section: Diskussionunclassified

“…27,28 In den letzten Jahren wurde in mehreren großen Fall-Kontroll-und Kohortenstudien das Risiko für Hautkrebs (SCC/in-situ-SCC und BCC) in Verbindung mit der Langzeiteinnahme von HCT untersucht. [29][30][31][32][33][34][35] Darüber hinaus wurde die Einnahme von HCT mit einem erhöhten Risiko für andere UV-induzierte Hauttumoren wie dem malignen Melanom (MM) in Verbindung gebracht. 35,36 Jüngste Metaanalysen bestätigen das erhöhte Risiko für NMSC und MM unter Einnahme von HCT.…”

Section: Introductionunclassified

Hydrochlorothiazid: Erhöhtes Risiko für atypisches Fibroxanthom und pleomorphes dermales Sarkom

Kuntz,

Grimm,

Hofmann

et al. 2024

J Deutsche Derma Gesell

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ZusammenfassungHintergrund und ZieleBisherige Arbeiten haben gezeigt, dass Hydrochlorothiazid (HCT) aufgrund seiner photokarzinogenen Wirkung einen Risikofaktor für Plattenepithelkarzinome (SCC) und Basalzellkarzinome (BCC) darstellt. Atypische Fibroxanthome (AFX) und pleomorphe dermale Sarkome (PDS), beides UV‐induzierte Tumoren, stellen eine seltene, aber zunehmende Tumorentität der Haut dar. In dieser Studie soll untersucht werden, ob die Einnahme von HCT bei Patienten mit AFX/PDS höher ist als bei Patienten mit SCC/BCC und ob dies ein Risikofaktor für die Entwicklung von AFX/PDS sein könnte.Patienten und MethodikIn einer retrospektiven Studie an vier deutschen Hautkrebszentren wurden AFX/PDS‐Fälle und SCC/BCC‐Kontrollen über einen Zeitraum von sieben Jahren (2013‐2019) geschlechts‐ und alters‐gematcht (1:3) auf die Einnahme von HCT und immunsuppressiven Medikamenten sowie auf Zweitmalignome und Diabetes mellitus untersucht.ErgebnisseInsgesamt wurden 146 AFX/PDS und 438 Kontrollen (SCC/BCC) in die Studie eingeschlossen. Die Einnahme von HCT war bei Patienten mit AFX/PDS (44,5%) im Vergleich zu Patienten mit SCC/BCC (25,3%) signifikant häufiger. Außerdem war Diabetes mellitus bei AFX/PDS‐Patienten signifikant häufiger.SchlussfolgerungenDiese Studie zeigt eine signifikant höhere Einnahme von HCT bei Patienten mit AFX/PDS im Vergleich zu SCC/BCC. Dies legt nahe, dass HCT ein Risikofaktor für AFX/PDS sein könnte. Darüber hinaus könnten ein Diabetes mellitus oder dessen Begleiterkrankungen mit einem erhöhten Risiko für AFX/PDS assoziiert sein.

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Hydrochlorothiazide use is associated with the risk of cutaneous and lip squamous cell carcinoma: A systematic review and meta-analysis

Cited by 11 publications

References 34 publications

Hydrochlorothiazide and increased risk of atypical fibroxanthoma and pleomorphic dermal sarcoma

Hydrochlorothiazide and increased risk of atypical fibroxanthoma and pleomorphic dermal sarcoma

HYDROchlorothiazide versus placebo to PROTECT polycystic kidney disease patients and improve their quality of life: study protocol and rationale for the HYDRO-PROTECT randomized controlled trial

Hydrochlorothiazid: Erhöhtes Risiko für atypisches Fibroxanthom und pleomorphes dermales Sarkom

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