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J Am Acad Dermatol. 2019 May 28. pii: S0190-9622(19)30859-X. doi: 10.1016/j.jaad.2019.05.055. [Epub ahead of print]

Use of antiepileptic drugs and risk of skin cancer: A nationwide case-control study.

Author information

1
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Denmark. Electronic address: kaskristensen@health.sdu.dk.
2
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Denmark; Department of Clinical Biochemistry & Pharmacology, Odense University Hospital, Odense, Denmark.
3
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
4
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Denmark.

Abstract

BACKGROUND:

Several antiepileptic drugs are photosensitizing; however, it is not known whether this confers an increased risk of skin cancer.

OBJECTIVE:

To examine the association between common antiepileptic drugs and basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM).

METHODS:

We conducted a nested case-control study identifying skin cancer cases in Denmark 2004-2015 matched 1:10 to disease-free controls. We estimated odds ratios (ORs) for skin cancer associated with high cumulative use of antiepileptic drugs (≥500 defined daily doses) compared with non-use.

RESULTS:

Most antiepileptic drugs were not associated with skin cancer. SCC was associated with use of carbamazepine (OR 1.88, 95%CI: 1.42 to 2.49) and lamotrigine (OR 1.57, 95%CI: 1.12 to 2.22) with evidence of a dose-response relationship for carbamazepine. The estimated absolute risks were low, e.g. 6335 person-years of high cumulative exposure to carbamazepine were required for one additional SCC to occur.

LIMITATIONS:

Data on important risk factors for skin cancer, e.g. sun exposure, were not available CONCLUSIONS: Most antiepileptic drugs were not associated with skin cancer, however, carbamazepine and lamotrigine were associated with SCC. These findings need to be replicated and characterized further in other settings and have no direct clinical implications.

KEYWORDS:

Antiepileptic drugs; adverse effects; cancer risk; epidemiology; malignant melanoma; nonmelanoma skin cancer; pharmacology; skin cancer

PMID:
31150714
DOI:
10.1016/j.jaad.2019.05.055

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