ARBs and cancer risk

ARBs and cancer risk

Do angiotensin receptor blockers (ARBs) increase the risk of cancer? In a widely reported study, researchers from Case Western Reserve performed a meta-analysis of 5 trials for which cancer data were available from more than 61,000 patients. Telmisartan was the ARB used in nearly 86% of the studies. Patients randomly assigned to receive ARBs had a rate of new cancer occurrence of 7.2% vs 6.0% for placebo (relative risk [RR], 1.08; 95% confidence interval [CI], 1.01-1.15; P = 0.016). The risk ratio was higher when the analysis was limited to trials where cancer was the prespecified endpoint (RR, 1.11; 95% CI, 1.04-1.18; P = 0.001). There was no difference in the rate of cancer deaths between the two groups. The authors conclude that this trial suggests that ARBs are associated with a modestly increased risk of new cancer diagnosis, but it is not possible to draw conclusions about the exact risk of cancer associated with each particular drug and further research is warranted (Lancet Oncology 14 June 2010; early online publication). ARBs are involved in the regulation of cell proliferation, angiogenesis, and tumor progression, which are possible mechanisms for these findings.