Chemopreventive Effects of Concomitant or Individual Use of Statins, Aspirin, Metformin, and Angiotensin Drugs: A Study Using Claims Data of 23 Million Individuals
by
, , , , and
Ching-Huan Wang
1,2
,
Chih-Wei Huang
2,†
,
Phung Anh Nguyen
3,4,5,†,
Ming-Chin Lin
1,6,7,
Chih-Yang Yeh
1,
Md. Mohaimenul Islam
2,8
,
Annisa Ristya Rahmanti
1,2 and
Hsuan-Chia Yang
1,2,4,9,* 1
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 106339, Taiwan
2
International Center for Health Information Technology (ICHIT), College of Medical Science and Technology, Taipei Medical University, Taipei 106339, Taiwan
3
Clinical Big Data Center, Office of Data Science, Taipei Medical University, Taipei 106339, Taiwan
4
Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
5
Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taoyuan 333321, Taiwan
6
Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
7
Taipei Neuroscience Institute, Taipei Medical University, Taipei 110301, Taiwan
8
AESOP Technology, Taipei 105076, Taiwan
9
Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Cancers 2022, 14(5), 1211; https://doi.org/10.3390/cancers14051211
Submission received: 13 January 2022
/
Revised: 9 February 2022
/
Accepted: 22 February 2022
/
Published: 25 February 2022
(This article belongs to the Special Issue Actual Preventive Drugs and Food Factors on Cancer)
Simple Summary
Medications for chronic diseases, such as tatins, aspirin, metformin, and angiotensin-converting-enzyme inhibitors/angiotensin II receptor blockers, are studied for decades, and a vast body of previous research has suggested potential repurposing of these medications for cancer prevention. However, a limited number of studies have analyzed the effect of various combinations of these four medications/classes on cancer risks. This study, using large databases, aimed to comprehensively analyze the composite chemopreventive effects of all possible combinations of these four medications/classes. We found no synergistic effect of multiple use of these agents on cancer prevention in this study. Our results may provide information or inspiration for researchers or clinicians to conduct future research on combinations with cancer-preventive potential to further determine the optimal strategy for chemoprevention against cancer.
Abstract
Despite previous studies on statins, aspirin, metformin, and angiotensin-converting-enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), little has been studied about all their possible combinations for chemoprevention against cancers. This study aimed to comprehensively analyze the composite chemopreventive effects of all the combinations. In this case-control study, health records were retrieved from claims databases of Taiwan’s Health and Welfare Data Science Center. Eligible cases were matched at a 1:4 ratio with controls for age and sex. Both cases and controls were categorized into 16 exposure groups based on medication use. A total of 601,733 cancer cases were identified. Cancer risks (denoted by adjusted odds ratio; 99% confidence interval) were found to be significantly decreased: overall risk of all cancers in statin-alone (0.864; 0.843, 0.886), aspirin-alone (0.949; 0.939, 0.958), and ACEIs/ARBs (0.982; 0.978, 0.985) users; prostate (0.924; 0.889, 0.962) and female breast (0.967; 0.936, 1.000) cancers in metformin-alone users; gastrointestinal, lung, and liver cancers in aspirin and/or ACEIs/ARBs users; and liver cancer (0.433; 0.398, 0.471) in statin users. In conclusion, the results found no synergistic effect of multiple use of these agents on cancer prevention. Use of two (statins and aspirin, statins and metformin, statins and ACEIs/ARBs, and aspirin and ACEIS/ARBs) showed chemopreventive effects in some combinations, while the use of four, in general, did not.
Keywords:
chemoprevention; cancer prevention; repurposing; synergistic effect; statin; aspirin; metformin; ACEI; ARB
