ARBs linked to modestly higher risk of cancer diagnosis

Angiotensin-receptor blockers (ARBs) appear to be associated with a modest increase in risk of a new cancer diagnosis, according to research published online June 14 in The Lancet Oncology, reported HealthDay News.

Ilke Sipahi, MD, of the Case Western Reserve University School of Medicine in Cleveland, and colleagues analyzed data from randomized controlled trials involving the 7 currently available ARBs. Five trials with 61,590 patients provided new-cancer data; 5 with 68,402 patients provided data on common types of solid organ cancers; and 8 with 93,515 patients offered data on cancer deaths.

The researchers found that patients assigned to receive ARBs had a higher risk of new cancer occurrence compared with controls (RR, 1.08), which rose to a RR of 1.11 only in trials where cancer was a prespecified end point. Among specific solid organ cancers, only new lung-cancer occurrence was significantly higher in patients receiving ARBs (RR, 1.25). ARBs were not linked to a significant difference in cancer deaths. Telmisartan was most commonly used as the ARB in trials with new-cancer data.

"Regulators must review the possible association between ARB use and cancer, and promptly report their findings. In the interim, we should use ARBs, particularly telmisartan, with greater caution. These drugs are often over-prescribed, as a result of aggressive marketing and in the absence of evidence that they are better than angiotensin-converting enzyme (ACE) inhibitors. ARBs can be reserved for patients with intolerance to ACE inhibitors," wrote the author of an accompanying comment.

Several co-authors and the comment author disclosed financial relationships with pharmaceutical companies or medical device makers.