The use of ace inhibitors influences the risk of progression of BD-IPMNs under follow-up.
Ace-inhibitors
Angiotensin II receptor blockers
Aspirin
Chemoprevention
IPMN
Statins
Journal
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
24
10
2021
revised:
13
03
2022
accepted:
28
03
2022
pubmed:
19
4
2022
medline:
12
5
2022
entrez:
18
4
2022
Statut:
ppublish
Résumé
Chemoprevention's ability to slow down or prevent the progression of BD-IPMNs is extremely appealing. Aspirin (ASA), Ace Inhibitors/Angiotensin Receptor Blockers (ACEIs/ARBs) and Statins (STATs) are frequently prescribed drugs with a possible beneficial effect on different cancer types. Their effect on IPMNs is largely unknown. To evaluate the association between the use of ASA, ACEIs/ARBs and STATs and the risk of progression of BD-IPMNs in follow-up. multicenter, retrospective cohort study on patients with presumed BD-IPMNs without relative or absolute indication for surgery. Pharmacological exposures and risk factors were collected. We identified clinically relevant progression (occurrence of radiological absolute or relative indication for surgery) and any progression (occurrence of clinically relevant progression OR any dimension increase OR the occurrence of new cysts). Overall 594 patients were included. ACEIs were associated with a lower occurrence of any progression (HR = 0.70; 95% CI 0.49-0.98, p = 0.04) and clinically relevant progression, HR = 0.42 (95% CI 0.20-0.88; p = 0.02). No significant effect was shown for factors associated with the occurrence of pancreas cancer such as smoking, alcohol consumption and 1st degree family history of pancreas cancer. Among pharmacological exposures, no convincing effect was shown for the chronic use of ASA, ARB and STAT. ACEIs might have an effect in slowing the progression of BD-IPMNs. ASA, STAT and ARBs show no convincing effect on the progression of BD-IPMNs. Further, prospective, and long-term multicenter studies are needed to verify such association and to define the potential underlying mechanisms.
Sections du résumé
BACKGROUND
BACKGROUND
Chemoprevention's ability to slow down or prevent the progression of BD-IPMNs is extremely appealing. Aspirin (ASA), Ace Inhibitors/Angiotensin Receptor Blockers (ACEIs/ARBs) and Statins (STATs) are frequently prescribed drugs with a possible beneficial effect on different cancer types. Their effect on IPMNs is largely unknown.
AIM
OBJECTIVE
To evaluate the association between the use of ASA, ACEIs/ARBs and STATs and the risk of progression of BD-IPMNs in follow-up.
MATERIALS AND METHODS
METHODS
multicenter, retrospective cohort study on patients with presumed BD-IPMNs without relative or absolute indication for surgery. Pharmacological exposures and risk factors were collected. We identified clinically relevant progression (occurrence of radiological absolute or relative indication for surgery) and any progression (occurrence of clinically relevant progression OR any dimension increase OR the occurrence of new cysts).
RESULTS
RESULTS
Overall 594 patients were included. ACEIs were associated with a lower occurrence of any progression (HR = 0.70; 95% CI 0.49-0.98, p = 0.04) and clinically relevant progression, HR = 0.42 (95% CI 0.20-0.88; p = 0.02). No significant effect was shown for factors associated with the occurrence of pancreas cancer such as smoking, alcohol consumption and 1st degree family history of pancreas cancer. Among pharmacological exposures, no convincing effect was shown for the chronic use of ASA, ARB and STAT.
CONCLUSIONS
CONCLUSIONS
ACEIs might have an effect in slowing the progression of BD-IPMNs. ASA, STAT and ARBs show no convincing effect on the progression of BD-IPMNs. Further, prospective, and long-term multicenter studies are needed to verify such association and to define the potential underlying mechanisms.
Identifiants
pubmed: 35431111
pii: S1424-3903(22)00109-0
doi: 10.1016/j.pan.2022.03.020
pii:
doi:
Substances chimiques
Angiotensin Receptor Antagonists
0
Angiotensin-Converting Enzyme Inhibitors
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
516-524Informations de copyright
Copyright © 2022 IAP and EPC. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest Prof Del Chiaro received a research grant from Haemonetics, Inc and is co-PI of a Boston Scientific sponsored study on the use of intra-operative pancreatoscopy in IPMN's patients. Prof Arnelo is co-PI of a Boston Scientific sponsored study on the use of intra-operative pancreatoscopy in IPMN's patients. Dr. Valente has been a consultant for Boston Scientific for lectures unrelated to the topic of the article. The other authors declare no possible conflicts of interest. Writing assistance: The current paper has undergone language editing from Alison M Dieden translations. The language editing was paid by Dr Roberto Valente's research grant from Cancerforskningsfonden Norrland/Lions CancerforskningsfondAMP 21-1058. Specific author contributions: Roberto Valente, Marco Del Chiaro and Gabriele Capurso planned the study. Roberto Valente, Giulia Zerboni, Laura Zarantonello, Giuseppe Vanella and Alessandro Fogliati collected the data. Roberto Valente performed the statistical analysis. Roberto Valente, Marco del Chiaro, Gabriele Capurso and Stefano Crippa interpreted data. Roberto Valente, Marco Del Chiaro and Gabriele Capurso drafted the manuscript. Stefano Crippa, Urban Arnelo, Giuseppe Vanella, Giulia Zerboni, Laura Zarantonello, Alessandro Fogliati, Paolo Giorgio Arcidiacono, Miroslav Vujasinovic, Johannes Matthias Lohr, Massimo Falconi, Gabriele Capurso and Marco Del Chiaro reviewed and approved the final draft.