Clopidogrel use and cancer-specific mortality: a population-based cohort study of colorectal, breast and prostate cancer patients

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21 Citations (Scopus)

Abstract

PURPOSE: Concerns were raised about the safety of antiplatelet thienopyridine derivatives after a randomized control trial reported increased risks of cancer and cancer deaths in prasugrel users. We investigate whether clopidogrel, a widely used thienopyridine derivative, was associated with increased risk of cancer-specific or all-cause mortality in cancer patients.

METHODS: Colorectal, breast and prostate cancer patients, newly diagnosed from 1998 to 2009, were identified from the National Cancer Data Repository. Cohorts were linked to the UK Clinical Practice Research Datalink, providing prescription records, and to the Office of National Statistics mortality data (up to 2012). Unadjusted and adjusted hazard ratios (HRs) for cancer-specific and all-cause mortality in post-diagnostic clopidogrel users were calculated using time-dependent Cox regression models.

RESULTS: The analysis included 10 359 colorectal, 17 889 breast and 13 155 prostate cancer patients. There was no evidence of an increase in cancer-specific mortality in clopidogrel users with colorectal (HR = 0.98 95% confidence interval (CI) 0.77, 1.24) or prostate cancer (HR = 1.03 95%CI 0.82, 1.28). There was limited evidence of an increase in breast cancer patients (HR = 1.22 95%CI 0.90, 1.65); however, this was attenuated when removing prescriptions in the year prior to death.

CONCLUSIONS: This novel study of large population-based cohorts of colorectal, breast and prostate cancer patients found no evidence of an increased risk of cancer-specific mortality among colorectal, breast and prostate cancer patients using clopidogrel.

Original languageEnglish
Pages (from-to)830-840
Number of pages11
JournalPharmacoepidemiology and Drug Safety
Volume24
Issue number8
Early online date27 May 2015
DOIs
Publication statusPublished - 04 Aug 2015

Keywords

  • Aged
  • Aged, 80 and over
  • Breast Neoplasms
  • Cause of Death
  • Colorectal Neoplasms
  • Databases, Factual
  • Drug Prescriptions
  • Female
  • Great Britain
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Safety
  • Pharmacoepidemiology
  • Platelet Aggregation Inhibitors
  • Proportional Hazards Models
  • Prostatic Neoplasms
  • Risk Assessment
  • Risk Factors
  • Ticlopidine
  • Time Factors
  • Treatment Outcome

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