1. Voriconazole and squamous cell carcinoma after lung transplantation: A multicenter study
- Author
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Amparo Solé, Erik A M Verschuuren, J. Mo, Fernanda P. Silveira, Piedad Ussetti, Oriol Manuel, Chien-Li Holmes-Liew, Muhammad Younus, Lianne G. Singer, Peter Chin-Hong, J. Yan, Eliane M. Billaud, C. Fegbeutel, Paolo Grossi, Denis Hadjiliadis, Shahid Husain, J. Aram, Deborah Levine, Richard G. Barbers, Bassem Hamandi, and Groningen Institute for Organ Transplantation (GIOT) more...
- Subjects
Lung Diseases ,Male ,Oncology ,lung disease ,Antifungal Agents ,Skin Neoplasms ,medicine.medical_treatment ,030230 surgery ,THERAPY ,030207 dermatology & venereal diseases ,0302 clinical medicine ,lung transplantation/pulmonology ,patient safety ,EPIDEMIOLOGY ,Medicine ,Immunology and Allergy ,Pharmacology (medical) ,malignant [complication] ,RISK ,Hazard ratio ,Immunosuppression ,Middle Aged ,Prognosis ,infection and infectious agents - fungal ,PRACTICE GUIDELINES ,complication: malignant ,Carcinoma, Squamous Cell ,antifungal [antibiotic] ,Female ,Lung Transplantation ,medicine.drug ,Cohort study ,Adult ,medicine.medical_specialty ,Adolescent ,infectious disease ,SOCIETY ,ANTIFUNGAL PROPHYLAXIS ,clinical research/practice ,Article ,Young Adult ,03 medical and health sciences ,antibiotic: antifungal ,health services and outcomes research ,Transplantation ,LONG-TERM VORICONAZOLE ,Internal medicine ,Humans ,Lung transplantation ,EXPOSURE ,Aged ,Retrospective Studies ,Voriconazole ,SKIN-CANCER ,business.industry ,Proportional hazards model ,Retrospective cohort study ,Transplant Recipients ,Surgery ,RECIPIENTS ,business ,Follow-Up Studies - Abstract
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. more...
- Published
- 2018