The renin–angiotensin system is an important mediator of tumor progression and metastasis.
A recent meta-analysis of randomized controlled trials reported an increased risk
of cancer with angiotensin receptor blockers. It is unknown whether angiotensin-converting
enzyme (ACE) inhibitors may have a similar effect. Our primary objective was to determine
the effect of ACE inhibitors on cancer occurrence and cancer death. Our secondary
objective was to determine the effect of ACE inhibitors on occurrence of gastrointestinal
(GI) cancers given previous concerns of increased risk. Systematic searches of SCOPUS
(covering MEDLINE, EMBASE, and other databases) and the Food and Drug Administration
official web site were conducted for all randomized controlled trials of ACE inhibitors.
Trials with ≥1 year of follow-up and enrolling a minimum of 100 patients were included.
Fourteen trials reported cancer data in 61,774 patients. This included 10 trials of
59,004 patients providing information on cancer occurrence, 7 trials of 37,515 patients
for cancer death, and 5 trials including 23,291 patients for GI cancer. ACE inhibitor
therapy did not have an effect on occurrence of cancer (I2 0%, risk ratio [RR] 1.01, 95% confidence interval [CI] 0.95 to 1.07, p = 0.78), cancer
death (I2 0%, RR 1.00, 95% CI 0.88 to 1.13, p = 0.95), or GI cancer (RR 1.09, 95% CI 0.88 to
1.35, p = 0.43). In conclusion, ACE inhibitors did not significantly increase or decrease
occurrence of cancer or cancer death. There was also no significant difference in
risk of GI cancer.
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Article Info
Publication History
Published online: May 25, 2011
Accepted:
March 11,
2011
Received in revised form:
March 11,
2011
Received:
January 31,
2011
Footnotes
Dr. Sipahi received an educational grant (2004) and lecture honoraria from Pfizer (once, 2007), and lecture honoraria from AstraZeneca (once, 2008) and Ranbaxy (once, 2010). Dr. Debanne is a member of the data monitoring committee for Centocor Research & Development, Inc. Dr. Simon serves on advisory boards for Cordis/Johnson & Johnson, Daiichi-Sankyo, Medicines Company, Medtronic Vascular, Portola, and Schering-Plough, and has received lecture honoraria from Accumetrics, Cordis/Johnson & Johnson, Daiichi-Sankyo, Eli Lilly, Medicines Company, Sanofi-Aventis, and Schering-Plough. Dr. Fang serves on an advisory panel for Novartis and as a consultant for ARCA Biopharma, Inc.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
