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Chronic inflammatory diseases, anti-inflammatory medications and risk of prostate cancer: a population-based case-control study.

ABSTRACT: BACKGROUND:Whether chronic inflammation increases prostate cancer risk remains unclear. This study investigated whether chronic inflammatory diseases (CID) or anti-inflammatory medication use (AIM) were associated with prostate cancer risk. METHODS:Fifty-five thousand nine hundred thirty-seven cases (all prostate cancer, 2007-2012) and 279,618 age-matched controls were selected from the Prostate Cancer Database Sweden. CIDs and AIMs was determined from national patient and drug registers. Associations were investigated using conditional logistic regression, including for disease/drug subtypes and exposure length/dose. RESULTS:Men with a history of any CID had slightly increased risk of any prostate cancer diagnosis (OR: 1.08; 95%CI: 1.04-1.12) but not 'unfavourable' (high-risk or advanced) prostate cancer. Generally, risk of prostate cancer was highest for shorter exposure times. However, a positive association was observed for asthma >?5?years before prostate cancer diagnosis (OR: 1.21; 95%CI: 1.05-1.40). Risk of prostate cancer was increased with prior use of any AIMs (OR: 1.26; 95%CI: 1.24-1.29). A positive trend with increasing cumulative dose was only observed for inhaled glucocorticoids (p?

SUBMITTER: Beckmann K

PROVIDER: S-EPMC6588859 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Chronic inflammatory diseases, anti-inflammatory medications and risk of prostate cancer: a population-based case-control study.

Beckmann Kerri K Russell Beth B Josephs Debra D Garmo Hans H Haggstrom Christel C Holmberg Lars L Stattin Pär P Van Hemelrijck Mieke M Adolfsson Jan J

BMC cancer 20190621 1

<h4>Background</h4>Whether chronic inflammation increases prostate cancer risk remains unclear. This study investigated whether chronic inflammatory diseases (CID) or anti-inflammatory medication use (AIM) were associated with prostate cancer risk.<h4>Methods</h4>Fifty-five thousand nine hundred thirty-seven cases (all prostate cancer, 2007-2012) and 279,618 age-matched controls were selected from the Prostate Cancer Database Sweden. CIDs and AIMs was determined from national patient and drug re ...[more]

PMID: 31226970

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Project description:BackgroundThis study aimed to determine whether the number of anti-hypertensive medication classes or any change in anti-hypertensive medication were associated with injurious fall among the community-dwelling older population of low socioeconomic status.MethodsUsing data from electronic medical records, we performed a nested case-control study among older Singapore residents (?60) of low socioeconomic status (N?=?210). Controls (n?=?162) were matched to each case (n?=?48) by age and gender. Variables with p?<?0.10 in univariate analysis were included in multivariate analysis. We used conditional logistic regression to assess the associations of the number of anti-hypertensive medication classes and change in anti-hypertensive medication with injurious falls. We also performed stepwise regressions as sensitivity analyses. p?<?0.05 was considered statistically significant.ResultsThe mean (±SD) age of participants was 78.1 (± 8.33) years; 127 (60.4%) were female, 189 (90.0%) were Chinese. Those on ?2 anti-hypertensive medication classes had an increased risk of experiencing an injurious fall compared to those not on any anti-hypertensive medication (OR?=?5.45; CI:1.49-19.93; p?=?0.01). Among those who were taking anti-hypertensive medication, those who had a change in the medication 180-day prior to injurious fall had a significantly increased risk of experiencing an injurious fall compared to those that did not report any change in anti-hypertensive medication (OR?=?3.88; CI:1.23-12.19; p?=?0.02). Sensitivity analyses generated consistent findings.ConclusionBoth ?2 anti-hypertensive medication classes and change in anti-hypertensive medication were associated with an increased risk of experiencing an injurious fall among the older population of low socioeconomic status. Our findings could guide prescribers to exercise caution in the initiation of anti-hypertensive medications or in making medication changes, especially among the older population of low socioeconomic status.

Project description:ObjectivesThis study aimed to investigate the importance of potentially inappropriate medications, number of medications and chronic conditions for the risk of hospitalisation among an elderly population.DesignThis is a case-control study.SettingPopulation-based study in 2013 of all individuals aged 75 years and older (17 203) in the county of Blekinge in the southeast of Sweden.ParticipantsA total of 2941 individuals were included who had at least one hospitalisation to a medical, geriatric and palliative, or orthopaedic ward during 2013. From this total, 81 were excluded because of incomplete data or absence of controls. In total, 5720 patients were included and formed 2860 risk sets matched on age and gender.Primary and secondary outcome measuresConditional logistic regression was used to analyse the odds for hospitalisation according to use of potentially inappropriate medication (PIM), number of chronic conditions and medicines using univariate and multivariate models. PIM was defined as long-acting benzodiazepines, tramadol, propiomazine and medicines with anticholinergic effect.ResultsThe univariate analysis for use of PIM showed a significant association with hospitalisation (OR 1.54, 95% CI 1.30 to 1.83). For the number of chronic conditions, the OR was increased and was significant from two or more chronic conditions, and for the number of medicines from the use of five or more medicines, in the univariate analysis. Use of PIM has no association with hospitalisation in the full model. The number of chronic conditions and medicines in the full models continued to have strong associations for hospitalisation, from five to seven chronic conditions (OR 1.86, 95% CI 1.49 to 2.33) and use of five to nine medicines (OR 1.46, 95% CI 1.21 to 1.77) at the same time.ConclusionThe number of chronic conditions and medications are important for the odds of hospitalisation, while the use of PIM, according to the definition used in this study, was no significant in the full model.

Project description:Use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with an increased relative risk of acute myocardial infarction (AMI), but the label warnings refer particularly to patients with cardiovascular risk factors. The magnitude of relative AMI risk for patients with and without cardiovascular risk factors varies between studies depending on the drugs and doses studied.The aim of our study was to estimate population-based relative AMI risks for individual and widely used NSAIDs, for a cumulative amount of NSAID use, and for patients with and without a prior history of cardiovascular risk factors.Based on data from the German Pharmacoepidemiological Research Database (GePaRD) of about 17 million insurance members from four statutory health insurance providers, for the years 2004-2009, a nested case-control study was conducted within a cohort of 3,476,931 new NSAID users classified into current, recent, or past users. Up to 100 controls were matched to each case by age, sex, and length of follow-up using risk set sampling. Multivariable conditional logistic regression was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Duration of NSAID use was calculated by the cumulative amount of dispensed defined daily doses (DDDs), and stratified analyses were conducted for potential effect modifiers.Overall, 17,236 AMI cases were matched to 1,714,006 controls. Elevated relative AMI risks were seen for current users of fixed combinations of diclofenac with misoprostol (OR 1.76, 95% CI 1.26-2.45), indometacin (1.69, 1.22-2.35), ibuprofen (1.54, 1.43-1.65), etoricoxib (1.52, 1.24-1.87), and diclofenac (1.43, 1.34-1.52) compared with past use. A low cumulative NSAID amount was associated with a higher relative AMI risk for ibuprofen, diclofenac, and indometacin. The relative risk associated with current use of diclofenac, fixed combinations of diclofenac with misoprostol, etoricoxib, and ibuprofen was highest in the younger age group (<60 years) and similar for patients with or without major cardiovascular risk factors.Relative AMI risk estimates differed among the 15 investigated individual NSAIDs. Diclofenac and ibuprofen, the most frequently used NSAIDs, were associated with a 40-50% increased relative risk of AMI, even for low cumulative NSAID amounts. The relative AMI risk in patients with and without cardiovascular risk factors was similarly elevated.

Dataset Information

Chronic inflammatory diseases, anti-inflammatory medications and risk of prostate cancer: a population-based case-control study.

Publications

Chronic inflammatory diseases, anti-inflammatory medications and risk of prostate cancer: a population-based case-control study.

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