Sirolimus use and risk of cutaneous squamous cell carcinoma (SCC) in solid organ transplant recipients (SOTRs) - 17/08/15
, Sarah T. Arron, MD, PhD b, E. Margaret Warton, MPH a, Charles P. Quesenberry, PhD a, Dana Weisshaar, MD cAbstract |
Background |
Little is known about the use of sirolimus for primary prevention of cutaneous squamous cell carcinoma (SCC) among solid organ transplant recipients (SOTRs).
Objective |
We examined the association between sirolimus exposure and incident SCC risk among SOTRs within Kaiser Permanente Northern California.
Methods |
Using a retrospective cohort of all Kaiser Permanente Northern California members given a diagnosis of SOTR from 2000 through 2010, we evaluated incident posttransplantation SCC risk in relation to sirolimus exposure. Sirolimus use was determined from electronic pharmacy records, and incident posttransplantation SCCs were identified from health plan electronic pathology records. We used extended Cox regression to examine the independent association between receipt of sirolimus and risk of SCC.
Results |
Among 3539 SOTRs, 488 were exposed to sirolimus and 47 developed an incident SCC. SCC risk was not associated with ever use of sirolimus (adjusted hazard ratio 1.18, 95% confidence interval 0.84-1.16) or cumulative duration of sirolimus exposure (adjusted hazard ratio 2.75, 95% confidence interval 0.84-9.04, comparing long-term users with nonusers).
Limitations |
No information was available for some known SCC risk factors, such as skin type and sun exposure.
Conclusions |
Among a large cohort of SOTRs, sirolimus exposure was not associated with a reduction in incident posttransplantation SCC risk.
Le texte complet de cet article est disponible en PDF.Key words : immunosuppression, nonmelanoma skin cancer, pharmacoepidemiology, sirolimus, solid organ transplantation, squamous cell carcinoma
Abbreviations used : aHR, CI, CNI, HR, KPNC, NMSC, SCC, SEER, SOTR
Plan
| Supported in part by the National Cancer Institute (R01 CA 166672 to Dr Asgari) and the Kaiser Foundation Research Institute (Community Benefits Grant KR021179 to Dr Asgari). |
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| Disclosure: Dr Asgari received grant funding to Kaiser Permanente from Pfizer Inc and Valeant Pharmaceuticals, but the research topic was not relevant to this work. Drs Arron, Quesenberry, and Weisshaar, and Ms Warton have no conflicts of interest to declare. |
Vol 73 - N° 3
P. 444-450 - septembre 2015 Retour au numéro
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