This study examined whether using topical calcineurin inhibitors (TCIs) for treating atopic dermatitis increases the risk of skin cancer (specifically keratinocyte carcinoma). The research was mandated by the FDA due to safety concerns about these medications.
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Association Between Topical Calcineurin Inhibitor Use and Keratinocyte Carcinoma Risk Among Adults With Atopic Dermatitis.
Association Between Topical Calcineurin Inhibitor Use and Keratinocyte Carcinoma Risk Among Adults With Atopic Dermatitis.
Maryam M Asgari, Ai-Lin Tsai, Lyndsay Avalos, Monica Sokil, Charles P Quesenberry Jr
DOI: 10.1001/jamadermatol.2020.2240
Observational Study
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93,746 participants
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2020
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15 citations
Key insights related to Protopic from this study:
- In adults, there is no evidence of increased skin cancer risk (keratinocyte carcinoma) associated with tacrolimus use compared to other treatments.
- There is no increased risk of skin cancer (keratinocyte carcinoma) associated with using Pimecrolimus, based on long-term safety studies.
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What is this paper about?
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How did the authors study this?
The researchers conducted a large retrospective study looking at medical records from Kaiser Permanente Northern California healthcare system from 2002-2017. They compared skin cancer rates between three groups: patients who used TCIs, patients who used topical corticosteroids, and patients who used neither medication. They analyzed medical records, pharmacy data, and pathology reports to track medication use and cancer diagnoses.
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What populations did the authors study?
The study included 93,746 adults aged 40 years or older with atopic dermatitis. The average age was 58.5 years, and 58.7% were women. The population was racially diverse, including White (50.5%), Asian (20.6%), Hispanic (12.2%), and Black (7.9%) patients. They followed patients for an average of 7.7 years.
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What did the authors find?
The researchers found no significant increase in skin cancer risk among patients who used TCIs compared to those who used topical corticosteroids or no treatment. This held true for both types of skin cancer studied (basal cell carcinoma and squamous cell carcinoma). They also found no increased risk with higher doses, more frequent use, or longer duration of TCI treatment.
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What conclusions can we draw?
The study suggests that using TCIs to treat atopic dermatitis does not increase the risk of skin cancer in adults. The authors note that these findings may provide reassurance about the safety of these medications for treating atopic dermatitis, though they acknowledge some limitations in their study design.
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