Kendzerska T, Pendharkar SR, Talarico R, Blades K, Mackenzie C, Gershon AS, Ayas N, Kaminska M, Fenton M, McBrien KA, Hawken S, Ratycz D, Lishchenko V, Owens RL, and Povitz M
Background: The real-world consequences of a Philips Respironics recall for positive airway pressure (PAP) devices distributed between 2009 and 2021 are unknown., Methods: We conducted a retrospective population-based study using health administrative databases (Ontario, Canada) on all new adult PAP users identified through the provincial funding system, free of cancer at baseline, who initiated (claimed) PAP treatment between 2012 and 2018. Everyone was followed from the PAP claim date to the earliest of incident cancer diagnosis, death or end of follow-up (March 2022). We used inverse probability of treatment weighting to balance baseline characteristics between individuals on recalled devices and those on devices from other manufacturers. Weighted hazard ratios of incident cancer were compared between groups., Results: Of 231 692 individuals identified, 58 204 (25.1%) claimed recalled devices and 173 488 (74.9%) claimed devices from other manufacturers. A meaningful baseline difference between groups (standardised difference ≥0.10) was noted only by location-relevant covariates; other variables were mostly equally distributed (standardised differences ≤0.06). Over a median (interquartile range) follow-up of 6.3 (4.9-8.0) years, 11 166 (4.8%) developed cancer: unadjusted rates per 10 000 person-years of 78.8 (95% CI 76.0-81.7) in the recall group versus 74.0 (95% CI 72.4-75.6) in others (p=0.0034). Propensity score weighting achieved excellent balance in baseline characteristics between groups (standardised differences ≤0.07). On a weighted sample, there was no statistical difference in the hazard of incident cancer between groups: cause-specific hazard ratio (recalled versus others) 0.97 (95% CI 0.89-1.06)., Conclusion: In our real-world population study, compared to other manufacturers and adjusting for confounders, recalled Philips Respironics PAP devices do not appear to be independently associated with developing cancer., Competing Interests: Conflict of interest: All authors declare they have no potential conflicts of interest. T. Kendzerska and A.S. Gershon are supported by the PSI (Physicians’ Services Incorporated) Foundation. Outside of the submitted work, S.R. Pendharkar has received honoraria from Jazz Pharmaceuticals, Paladin Labs and the International Centre for Professional Development in Health and Medicine for participation in educational activities, and grant funding from Jazz Pharmaceuticals. Outside of the submitted work, M. Povitz has received a fellowship grant from Paladin Labs and contract research from Jazz Pharmaceuticals. Outside of the submitted work, N. Ayas has received a speaker honorarium from ResMed, and has been a consultant with EISAI, Jazz and Powell Mansfield. Outside of the submitted work, M. Kaminska is a consultant for Biron Soins du Sommeil and reports a Philips investigator-initiated research grant (pending). Outside of the submitted work, the University of California San Diego (UCSD) Sleep Medicine Center received a donation from ResMed., (Copyright ©The authors 2024. For reproduction rights and permissions contact permissions@ersnet.org.)