Tranexamic acid use is not associated with the risk of melanoma in Danish women: A nested case-control study using Danish health registries |
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| Affiliation: | 1. Department of Plastic, and Breast Surgery, Aarhus University Hospital, Denmark;2. Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Denmark;3. Department of Plastic Surgery, Copenhagen University Hospital - Herlev and Gentofte, Denmark;4. Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Denmark;1. Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France;2. Department of Applied and Public Economics, and Political Economy, Complutense University of Madrid, Madrid, Spain;3. Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle Upon Tyne, United Kingdom;4. EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal;5. Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal;6. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal;1. Department of Epidemiology, Radiation Effects Research Foundation, 5-2, Hijiyama Park, Minami-ku, Hiroshima City, Hiroshima 732-0815, Japan;2. Division of International Health Policy Research, Institution for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;3. Research Department, Fondazione IRCSS, Istituto Nazionale dei Tumouri, Via Venezian 1, 20133, Milan, Italy;1. CONACYT - Instituto Nacional de Cancerología, Mexico City, Mexico;2. Dirección de Investigación, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico;3. Dirección de Investigación, Instituto Nacional de Cancerología, Mexico City, Mexico;4. Departamento de Tumores Mamarios, Instituto Nacional de Cancerología, Mexico City, Mexico;5. Servicio de Oncología, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico;6. Departmento de Tumores Ginecológicos, Instituto Nacional de Cancerología, Mexico City, Mexico;7. Departmento de Tumores Urológicos, Instituto Nacional de Cancerología, Mexico City, Mexico;8. Servicio de Urología, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico;9. Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México and Instituto Nacional de Cancerología, Mexico City, Mexico;1. Department of Mathematics and Statistics, Sam Houston State University, Huntsville, TX, USA;1. Department of Obstetrics and Gynecology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China;2. Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 201204, China |
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| Abstract: | BackgroundRepurposing already approved drugs in a cancer setting has gained increasing interest in recent years. Tranexamic acid is an anti-fibrinolytic drug that has recently been suggested as an anti-cancer drug due to its anti-inflammatory and anti-carcinogenic effects in animal studies. In this study, we aimed to investigate the possible melanoma-preventive role of tranexamic acid in Danish women.MethodIn this nested case-control study, we identified female cases 18–60 years with first-time melanoma during 2000–2015 and age-matched them with 10 female controls. The odds ratio (OR) of melanoma with tranexamic acid ever- or high use (≥ 100,000 mg) was estimated using conditional logistic regression.ResultsA total of 7986 women with incident melanoma were eligible for study inclusion and were matched to 79,860 controls. Most exposed cases and controls were exposed to low cumulative doses of tranexamic acid corresponding to around 5 days of continuous treatment (1000 mg 3 times daily) for the presumed main indication, i.e., menorrhagia.The crude OR associating tranexamic ever use with melanoma was 1.04 (95% CI 0.98–1.11, p = 0.20), and the adjusted OR was 1.03 (0.97–1.10, p = 0.32). We found no dose-response pattern or effect measure modification by age, histologic type, localization, or clinical stage. However, prolonged use with cumulative doses of tranexamic acid (≥ 100,000 mg) was associated with an increased risk of melanoma (adjusted OR 1.23,95 %, CI 0.96–1.56), compared with non-use.ConclusionWe found no association between tranexamic acid use and the risk of melanoma in Danish women. This could be explained by underlying dose- or biological factors, and sporadic use patterns. A higher risk of melanoma was seen among prolonged users which could be due to surveillance bias. |
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| Keywords: | Tranexamic acid Repurposing Melanoma Risk Case-control |
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