No excess pancreatic cancer risk with dihydropyridine calcium channel blockers, study says

Exposure to dihydropyridine calcium channel blockers does not appear to put patients at increased risk of developing pancreatic cancer as compared with thiazide diuretics, as shown in a large study.

The study used data from the UK Clinical Practice Research Datalink and included 702,448 patients with 3.3 million person‐years of follow‐up. Researchers applied Cox proportional hazards models that were weighted using standardized morbidity ratio based on calendar time‐specific propensity scores.

Of the patients, 344,480 were dCCB initiators and 357,968 were thiazide diuretic initiators. Over a median follow-up of 4.1 and 5.0 years (including a 1‐year lag period), 545 and 707 pancreatic cancer cases were documented in the dCCB and thiazide diuretic groups.

The corresponding weighted incidence rates of pancreatic cancer were 37.2 (95 percent confidence interval [CI], 34.1–40.4) per 100,000 person‐years with dCCBs and 39.4 (95 percent CI, 36.1–42.9) per 100,000 person‐years with thiazide diuretics.

Multivariable analyses showed no significant association between dCCB use and an increased risk of pancreatic cancer (weighted hazard ratio, 0.93, 95 percent CI, 0.80–1.09). Results were consistent in secondary analyses.

The present data provide reassurance regarding the long‐term pancreatic cancer safety of dCCBs.

While the biological mechanisms underlying a possible association between dCCBs and pancreatic cancer are limited, it has been suggested that certain blood pressure-lowering drug classes such dCCBs have the potential to improve prognosis and survival in patients with pancreatic cancer. [Anticancer Drugs 2020;31:737-741]