- Prescribing Advice for GPs - https://www.prescriber.org.uk -

ARB cancer link

The Lancet Oncology has published the results of a meta-analysis that aimed to assess the association between angiotensin receptor blockers (ARBs) and the risk of cancer. This study has been reported in the general media (BBC).

This analysis included studies involving one of the seven currently licensed ARBs provided that the study lasted for more than 1 year and recruited at least 100 participants. New cancer data were available for 61,590 participants in five studies, common solid organ cancer data were available for 68,402 participants in another five studies and cancer death data were available for 93,515 participants from eight studies.

The analysis found a statistically significant increase in the risk of cancer in the analysis of all studies. This increase remained when only those studies that included cancer as a prespecified endpoint were reviewed (RR 1.11 95% CI 1·04-1·18, p=0·001). No difference was identified in cancer deaths.

The authors conclude that, "ARBs are associated with a modestly increased risk of new cancer diagnosis". They recommend that these findings warrant further investigation. Patients taking these drugs are advised to contact their GP if they are concerned.

Action: Clinicians should be aware of this study. Patients can be reassured that more research is needed and that an association does not prove "cause and effect". This analysis does present the opportunity to switch treatment to ACE inhibitors where these drugs have not been tried previously.