Association Between the Overall Risk of Prostate Cancer and Use of Calcium Channel Blockers: A Systematic Review and Meta-analysis

• Published in: Clinical therapeutics Vol. 42; no. 9; pp. 1715 - 1727.e2
• Main Authors: Yang, Hui, Yu, Yahui, Hu, Xiaopeng, Wang, Wei, Yang, Xiaoyong, Liu, Hang, Ren, Liang, Zhang, Xiaodong, Feng, Xin, Liu, Lihong
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2020; Elsevier Limited
• Subjects: Antihypertensives; Bias; Calcium; Calcium channel blockers; Calcium Channel Blockers - administration & dosage; Calcium Channel Blockers - adverse effects; Chemotherapy; Clinical trials; cumulative duration; Drug therapy; fusion gene; Health risks; Heterogeneity; Humans; Hypertension; Hypertension - drug therapy; Male; Meta-analysis; metabolic factors; Prostate cancer; Prostatic Neoplasms - epidemiology; Quality assessment; Quality control; Risk; Sensitivity analysis; Statistical analysis; Subgroups; Systematic review; United States > US; meta-analysis; prostate cancer; cumulative duration; calcium channel blockers; fusion gene; metabolic factors
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/j.clinthera.2020.06.021

Although calcium channel blockers (CCBs) are now commonly prescribed to treat hypertension as a first-line drug therapy, their impact on prostate cancer (PCa) is unclear. This systematic review and meta-analysis was conducted to determine the association between CCB use and the overall risk of PCa. PubMed, EMBASE, and Cochrane were searched up to December 26, 2019, stratified according to statistical method of outcome [odd ratios (ORs), relative ratios (RRs), hazard ratios (HRs)] and cumulative duration of CCB use. The quality assessment of included studies was evaluated by using the Newcastle–Ottawa Scale. Fixed effects models were used to study the association between CCB use and the risk of PCa. Between-study heterogeneity was quantified by using Cochran's Q-statistic and I2 statistics. Sensitivity analysis was performed by excluding the studies one by one, and publication bias was analyzed by using funnel plots. Nineteen studies with 1,418,407 patients were identified for inclusion in the meta-analysis, which was based on the comparison of cohort studies, nested case–control studies, and case–control studies. Pooled estimates showed a RR of 1.08 (95% CI, 1.05–1.11; P < 0.00001) and a HR of 1.07 (95% CI, 1.02–1.13; P = 0.008) for association between CCB use and the risk of PCa. In addition, the results of subgroup analysis showed that CCB users of <5 years had an 8% increased overall risk of PCa (RR, 1.08; 95% CI, 1.04–1.12; P = 0.0001), and CCB users of 5–10 years had a 13% increased overall risk of PCa (RR, 1.13; 95% CI, 1.04–1.23; P = 0.003). CCB use had a tendency to increase the overall risk of PCa, and cumulative duration of CCB use might also be positively correlated with the overall risk of PCa. •Calcium channel blockers use significantly increased the overall risk of prostate cancer•Cumulative duration of calcium channel blockers use might be positively correlated with the overall risk of prostate cancer•TMPRSS2:ERG or T2E (fusion gene) might be a reversal factor in the relationship between calcium channel blockers use and prostate cancer risk