背景:近年来,在癌症环境中重新使用已批准的药物引起了越来越多的兴趣。氨甲环酸是一种抗纤维蛋白溶解药物,由于其在动物研究中的抗炎和抗癌作用,最近被建议作为抗癌药物。在这项研究中,我们旨在研究氨甲环酸对丹麦女性黑色素瘤的预防作用.
方法:在这项嵌套病例对照研究中,我们确定了2000-2015年期间18-60岁的女性首次黑色素瘤病例,并将其年龄与10名女性对照进行匹配.使用条件逻辑回归估计氨甲环酸过量或大量使用(≥100,000mg)的黑色素瘤的比值比(OR)。
结果:共有7986名患有黑色素瘤的女性符合纳入研究的条件,并与79,860名对照组相匹配。大多数暴露病例和对照暴露于低累积剂量的氨甲环酸,相当于连续治疗约5天(1000毫克,每天3次),用于假定的主要适应症。即,月经过多.与黑色素瘤相关的粗OR为1.04(95%CI0.98-1.11,p=0.20),调整后的OR为1.03(0.97-1.10,p=0.32)。我们没有发现剂量反应模式或效应测量随年龄的变化,组织学类型,本地化,或临床阶段。然而,长期服用累积剂量的氨甲环酸(≥100,000mg)与黑色素瘤的风险增加相关(调整后的OR为1.23,95%,CI0.96-1.56),与不使用相比。
结论:我们发现丹麦女性使用氨甲环酸与黑色素瘤风险之间没有关联。这可以用潜在的剂量或生物学因素来解释,和零星的使用模式。在长期使用者中发现黑色素瘤的风险较高,这可能是由于监测偏见。
Repurposing already approved drugs in a cancer setting has gained increasing interest in recent years. Tranexamic acid is an anti-fibrinolytic drug that has recently been suggested as an anti-cancer drug due to its anti-inflammatory and anti-carcinogenic effects in animal studies. In this
study, we aimed to investigate the possible melanoma-preventive role of tranexamic acid in Danish women.
In this nested case-control
study, we identified female cases 18-60 years with first-time melanoma during 2000-2015 and age-matched them with 10 female controls. The odds ratio (OR) of melanoma with tranexamic acid ever- or high use (≥ 100,000 mg) was estimated using conditional logistic regression.
A total of 7986 women with incident melanoma were eligible for
study inclusion and were matched to 79,860 controls. Most exposed cases and controls were exposed to low cumulative doses of tranexamic acid corresponding to around 5 days of continuous treatment (1000 mg 3 times daily) for the presumed main indication, i.e., menorrhagia. The crude OR associating tranexamic ever use with melanoma was 1.04 (95% CI 0.98-1.11, p = 0.20), and the adjusted OR was 1.03 (0.97-1.10, p = 0.32). We found no dose-response pattern or effect measure modification by age, histologic type, localization, or clinical stage. However, prolonged use with cumulative doses of tranexamic acid (≥ 100,000 mg) was associated with an increased risk of melanoma (adjusted OR 1.23,95 %, CI 0.96-1.56), compared with non-use.
We found no association between tranexamic acid use and the risk of melanoma in Danish women. This could be explained by underlying dose- or biological factors, and sporadic use patterns. A higher risk of melanoma was seen among prolonged users which could be due to surveillance bias.