Zolpidem Administration and Risk of Hepatocellular Carcinoma: A Case-Control Study in Taiwan

Abstract

Background/Objectives: Previous studies showed that zolpidem use could be associated with increased cancer risk, but the role of zolpidem on hepatocellular carcinoma (HCC) risk remains undetermined. The study purpose was to examine the association between HCC risk and zolpidem use in Taiwan.Methods: Using the database from the Taiwan National Health Insurance Program, we designed a case-control study which consisted of 77986 subjects aged 20 years or older with newly diagnosed HCC as the case group, and 77986 subjects without HCC as the control group, from 2000 to 2011. Ever use of zolpidem was defined as a subject who had at least a prescription for zolpidem before the index date. Never use was defined as a subject who did not have a prescription for zolpidem before the index date. The association between HCC risk and zolpidem use was determined by the odds ratio (OR) and 95% confidence interval (CI) in a multivariable logistic regression model.Results: After adjustment for confounding factors, the adjusted OR of HCC was 1.05 (95% CI 0.97, 1.13) for subjects with ever use of zolpidem, compared with never use of zolpidem. The adjusted OR of HCC was 1.01 for subjects with increasing cumulative duration of zolpidem use for every 1 year (95% CI 0.99, 1.03), compared with never use of zolpidem.Conclusion: There is no significant association between HCC risk and zolpidem use. There is no duration-dependent effect of zolpidem use on HCC risk.

Proton Pump Inhibitors and Risk of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B or C

“…One population-based case-control study from Taiwan failed to detect a significant association between PPI use and the risk of developing HCC after adjusting for multiple confounders and excluding cases in which PPIs were administered within 1 year of HCC diagnosis. (33) However, that study included only a small proportion of patients with HBV (6.9%) or HCV (5.8%) and involved fewer patients than did the current study. In contrast, another recent study that included a large, well-defined cohort of HCV-infected veterans without cirrhosis in the United States revealed an association between PPI use and the risk of progression to liver cirrhosis, hepatic decompensation, and HCC.…”

“…(15) Nevertheless, the association between PPI use and HCC risk in patients chronically infected with hepatitis B virus (HBV) has been less clear. (33) Therefore, to help elucidate the association between PPI use and the risk of developing HCC among aRtICle INFoRMatIoN: patients with chronic HBV or HCV infections, we performed a population-based cohort study throughout Taiwan using the Longitudinal Health Insurance Database (LHID).…”

Letter: cohort study examining the association between proton pump inhibitor therapy and risk of hepatocellular carcinoma in Taiwan

“…Studies have suggested that nonviral hepatocellular carcinoma (HCC) is becoming a significant subgroup of HCC in East Asia. 1,2 This region has been endemic for chronic hepatitis C (HCV) and chronic hepatitis B (HBC), which resulted in a high incidence of viral-associated HCC. In Taiwan, it was estimated that approximately 20% of HCC cases are nonviral induced and 80% of them are related to chronic viral hepatitis.…”

“…In Taiwan, it was estimated that approximately 20% of HCC cases are nonviral induced and 80% of them are related to chronic viral hepatitis. [2][3][4][5][6][7] The proportion of nonviral induced HCC is still increasing because the prevalence of viral HCC is decreasing due to the success of universal vaccination 8 and anti-viral therapy. 9…”

Predialysis chronic kidney disease correlates with increased risk of pyogenic liver abscess: a population-based cohort study

“…All comorbidities were diagnosed based on ICD-9 codes. The accuracy of ICD-9 codes has been discussed in previous studies [33][34][35][36][37][38][39][40][41][42][43].…”