6533b7d6fe1ef96bd1266770
RESEARCH PRODUCT
Voriconazole and squamous cell carcinoma after lung transplantation: A multicenter study
Amparo SoléErik A M VerschuurenJ. MoFernanda P. SilveiraPiedad UssettiOriol ManuelChien-li Holmes-liewMuhammad YounusLianne G. SingerPeter Chin-hongJ. YanEliane M. BillaudC. FegbeutelPaolo GrossiDenis HadjiliadisShahid HusainJ. AramDeborah LevineRichard G. BarbersBassem Hamandisubject
Lung DiseasesMaleOncologylung diseaseAntifungal AgentsSkin Neoplasmsmedicine.medical_treatment030230 surgeryTHERAPY030207 dermatology & venereal diseases0302 clinical medicinelung transplantation/pulmonologypatient safetyEPIDEMIOLOGYMedicineImmunology and AllergyPharmacology (medical)malignant [complication]RISKHazard ratioImmunosuppressionMiddle AgedPrognosisinfection and infectious agents - fungalPRACTICE GUIDELINEScomplication: malignantCarcinoma Squamous Cellantifungal [antibiotic]FemaleLung Transplantationmedicine.drugCohort studyAdultmedicine.medical_specialtyAdolescentinfectious diseaseSOCIETYANTIFUNGAL PROPHYLAXISclinical research/practiceArticleYoung Adult03 medical and health sciencesantibiotic: antifungal; clinical research/practice; complication: malignant; health services and outcomes research; infection and infectious agents - fungal; infectious disease; lung disease; lung transplantation/pulmonology; patient safety; Immunology and Allergy; Transplantation; Pharmacology (medical)LONG-TERM VORICONAZOLEInternal medicineHumansLung transplantationEXPOSUREAgedRetrospective StudiesVoriconazoleTransplantationSKIN-CANCERbusiness.industryProportional hazards modelRetrospective cohort studyantibiotic: antifungalhealth services and outcomes researchTransplant RecipientsSurgeryTransplantationRECIPIENTSVoriconazolebusinessFollow-Up Studiesdescription
This study evaluated the independent contribution of voriconazole to the development of squamous cell carcinoma (SCC) in lung transplant recipients, by attempting to account for important confounding factors, particularly immunosuppression. This international, multicenter, retrospective, cohort study included adult patients who underwent lung transplantation during 2005-2008. Cox regression analysis was used to assess the effects of voriconazole and other azoles, analyzed as time-dependent variables, on the risk of developing biopsy-confirmed SCC. Nine hundred lung transplant recipients were included. Median follow-up time from transplantation to end of follow-up was 3.51 years. In a Cox regression model, exposure to voriconazole alone (adjusted hazard ratio 2.39, 95% confidence interval 1.31-4.37) and exposure to voriconazole and other azole(s) (adjusted hazard ratio 3.45, 95% confidence interval 1.07-11.06) were associated with SCC compared with those unexposed after controlling for important confounders including immunosuppressants. Exposure to voriconazole was associated with increased risk of SCC of the skin in lung transplant recipients. Residual confounding could not be ruled out because of the use of proxy variables to control for some confounders. Benefits of voriconazole use when prescribed to lung transplant recipients should be carefully weighed versus the potential risk of SCC. EU PAS registration number: EUPAS5269.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-06-22 |