Common blood pressure drugs may raise cancer risk
Posted on Saturday, 19th June 2010
A widely used class of blood pressure drugs may slightly increase the risk of cancer, US researchers said, and they are calling on regulators to take a closer look.
They said an analysis of available data on drugs in the class known as angiotensin-receptor blockers showed patients were 1.2 per cent more likely to be diagnosed with a new cancer over four years than others who did not take the drugs.
Most patients in the trials (86 per cent) took German drugmaker Boehringer Ingelheim's telmisartan, sold as Micardis.
"The increased risk of new cancer occurrence is modest but significant," Dr Ilke Sipahi and colleagues from Case Western Reserve University in Cleveland in the journal Lancet Oncology.
There were not enough data in the studies to say if individual drugs in the class raise the risk or if it is a so-called class effect shared by all such drugs.
Even so, Dr Steven Nissen, a cardiologist at the Cleveland Clinic, said in a commentary the findings were "disturbing and provocative, raising crucial drug safety questions for practitioners and the regulatory community."
He said regulators need to look more closely at the risk of cancer with ARB use and that doctors should be more cautious about prescribing ARBs, and especially Micardis.
Privately held Boehringer Ingelheim defended the safety of its drug, saying in a statement its own "internal safety data analysis of primary data contradicts the conclusions" of an increased cancer risk.
Sipahi and colleagues did a so-called meta-analysis, pooling all publicly available data from randomised trials of ARBs published before November 2009.
Other drugs in the class include Merck & Co's Cozaar, sold generically as losartan; Diovan or valsartan made by Swiss drug firm Novartis; irbesartan, jointly marketed by Sanofi-Aventi and Bristol-Myers Squibb as Avapro; Daiichi Sankyo's Benicar or olmesartan; and Solvay Pharmaceuticals' Teveten or eprosartan.
Overall, they found that patients taking the drugs had 7.2 per cent risk of having a new cancer diagnosis, compared with 6 per cent risk for patients in the control groups.
When they looked at cancer types, only lung cancer stood out, with 0.9 per cent of patients taking blood pressure drugs developing a new lung cancer compared with 0.7 per cent of patients in the control arm.
The drugs did not appear to increase the risk of death from cancer, but the team said cancers can develop slowly and cancer deaths might not show up in the relatively short studies.
Just three out of seven FDA-approved drugs - telmisartan, losartan, and candesartan - were studied, and it is not clear what affect other drugs in the class might have on cancers.
Nevertheless, they said given how widely the drugs are used, the risk is worth further study.
Other experts stressed that patients need to keep taking their blood pressure medications.
"At the moment there isn't enough evidence to draw any firm conclusions about how blood pressure drugs might affect cancer risk and this will need further investigation," Martin Ledwick, head information nurse at Cancer Research UK, said in a statement.