BETA-BLOCKERS DO NOT REDUCE BREAST CANCER RECURRENCE
NEW YORK (Reuters Health) May 21 - Contrary to
some earlier reports, beta-blockers and other antihypertensive drugs do
not appear to attenuate the risk of breast cancer recurrence, according
to results from a Danish nationwide prospective cohort study.
Earlier studies have suggested that beta-blockers, angiotensin-converting enzyme inhibitors (ACEi), and angiotensin receptor blockers (ARBs) decrease the risk of recurrence or improved survival in women with breast cancer, although results have been inconsistent.
For the new study, Dr. Gitte Vrelits Sorensen from University Hospital, Aarhus, Denmark and colleagues used data from Denmark's population-based medical and prescription registries (covering roughly 5.6 million inhabitants) to estimate the associations between use of beta-blockers, ACEi, and ARBs and breast cancer recurrence.
There were 3414 breast cancer recurrences during 113,799 person-years (median follow-up, 6.8 years; maximum follow-up, 10 years), according to a report online May 6th in the Journal of Clinical Oncology.
Compared with never users, users of any beta-blocker had a slightly lower recurrence risk (9% lower) in unadjusted models and a slightly higher recurrence risk (30% higher) in adjusted models.
Different beta-blockers had different effects: exclusive use of metoprolol or sotalol seemed to increase the risk (by 50% and 100%, respectively), whereas other beta-blockers seemed to have null association with breast cancer recurrence.
"These may reflect chance findings arising from small subgroups," the researchers caution.
The increased risk associated with metoprolol
persisted only in estrogen receptor-positive patients (vs estrogen
receptor-negative patients) and was stronger before menopause (a
2.6-fold increase) than afterward (a 30% increase).
The impact of ACEi or ARB use on breast cancer recurrence was insignificant, neither increasing nor decreasing the risk.
"Our data do not support the hypothesis that beta-blockers attenuate breast cancer recurrence risk," the investigators conclude.
Dr. Sorensen did not respond to a request for comments on this report.
SOURCE: http://bit.ly/10mpxnM
J Clin Oncol 2013.
Earlier studies have suggested that beta-blockers, angiotensin-converting enzyme inhibitors (ACEi), and angiotensin receptor blockers (ARBs) decrease the risk of recurrence or improved survival in women with breast cancer, although results have been inconsistent.
For the new study, Dr. Gitte Vrelits Sorensen from University Hospital, Aarhus, Denmark and colleagues used data from Denmark's population-based medical and prescription registries (covering roughly 5.6 million inhabitants) to estimate the associations between use of beta-blockers, ACEi, and ARBs and breast cancer recurrence.
There were 3414 breast cancer recurrences during 113,799 person-years (median follow-up, 6.8 years; maximum follow-up, 10 years), according to a report online May 6th in the Journal of Clinical Oncology.
Compared with never users, users of any beta-blocker had a slightly lower recurrence risk (9% lower) in unadjusted models and a slightly higher recurrence risk (30% higher) in adjusted models.
Different beta-blockers had different effects: exclusive use of metoprolol or sotalol seemed to increase the risk (by 50% and 100%, respectively), whereas other beta-blockers seemed to have null association with breast cancer recurrence.
"These may reflect chance findings arising from small subgroups," the researchers caution.
The impact of ACEi or ARB use on breast cancer recurrence was insignificant, neither increasing nor decreasing the risk.
"Our data do not support the hypothesis that beta-blockers attenuate breast cancer recurrence risk," the investigators conclude.
Dr. Sorensen did not respond to a request for comments on this report.
SOURCE: http://bit.ly/10mpxnM
J Clin Oncol 2013.
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