Joosse Arjen, Koomen Elsje R, Casparie Mariël K, Herings Ron M C, Guchelaar Henk-Jan, Nijsten Tamar
Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands.
J Invest Dermatol. 2009 Nov;129(11):2620-7. doi: 10.1038/jid.2009.201. Epub 2009 Jul 9.
This case-control study investigates the potential chemoprophylactic properties of non-steroidal anti-inflammatory drugs (NSAIDs) on the incidence of cutaneous melanoma (CM). Data were extracted from the Dutch PHARMO pharmacy database and the PALGA pathology database. Cases had a primary CM between 1991 and 2004, were >or=18 years, and were observed for 3 years in PHARMO before diagnosis. Controls were matched for date of birth, gender, and geographical region. NSAIDs and acetylsalicylic acids (ASAs) were analyzed separately. Adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated using multivariable logistic regression, and the results were stratified across gender. A total of 1,318 CM cases and 6,786 controls were eligible to enter the study. CM incidence was not significantly associated with ever ASA use (adjusted OR: 0.92, 95% CI: 0.76-1.12) or ever non-ASA NSAID use (adjusted OR: 1.10, 95% CI: 0.97-1.24). However, continuous use of low-dose ASAs was associated with a significant reduction of CM risk in women (adjusted OR: 0.54, 95% CI: 0.30-0.99) but not in men (OR: 1.01, 95% CI: 0.69-1.47). A significant trend (P=0.04) from no use, non-continuous use to continuous use was observed in women. Continuous use of low-dose ASAs may be associated with a reduced incidence of CM in women, but not in men.
这项病例对照研究调查了非甾体抗炎药(NSAIDs)对皮肤黑色素瘤(CM)发病率的潜在化学预防特性。数据来自荷兰PHARMO药房数据库和PALGA病理学数据库。病例在1991年至2004年间患有原发性CM,年龄≥18岁,在PHARMO中诊断前观察3年。对照根据出生日期、性别和地理区域进行匹配。NSAIDs和乙酰水杨酸(ASA)分别进行分析。使用多变量逻辑回归计算调整后的优势比(OR)和95%置信区间(CI),结果按性别分层。共有1318例CM病例和6786例对照符合纳入研究的条件。CM发病率与曾经使用ASA(调整后的OR:0.92,95%CI:0.76 - 1.12)或曾经使用非ASA的NSAIDs(调整后的OR:1.10,95%CI:0.97 - 1.24)无显著关联。然而,持续使用低剂量ASA与女性CM风险显著降低相关(调整后的OR:0.54,95%CI:0.30 - 0.99),但与男性无关(OR:1.01,95%CI:0.69 - 1.47)。在女性中观察到从不使用、非持续使用到持续使用的显著趋势(P = 0.04)。持续使用低剂量ASA可能与女性CM发病率降低相关,但与男性无关。