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Long-Term Risk of S...
Long-Term Risk of Skin Cancer and Lymphoma in Users of Topical Tacrolimus and Pimecrolimus : Final Results from the Extension of the Cohort Study Protopic Joint European Longitudinal Lymphoma and Skin Cancer Evaluation (JOELLE)
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Arana, Alejandro (author)
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Pottegård, Anton (author)
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- Kuiper, Josephina G. (author)
- Karolinska Institutet
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Booth, Helen (author)
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- Reutfors, Johan (author)
- Karolinska Institutet
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Calingaert, Brian (author)
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Lund, Lars Christian (author)
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Crellin, Elizabeth (author)
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- Schmitt-Egenolf, Marcus, 1966- (author)
- Umeå universitet,Avdelningen för medicin
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Kaye, James A. (author)
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Gembert, Karin (author)
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Rothman, Kenneth J. (author)
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- Kieler, Helle (author)
- Karolinska Institutet
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Dedman, Daniel (author)
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Houben, Eline (author)
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Gutiérrez, Lia (author)
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Hallas, Jesper (author)
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Perez-Gutthann, Susana (author)
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(creator_code:org_t)
- Dove Medical Press, 2021
- 2021
- English.
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In: Clinical Epidemiology. - : Dove Medical Press. - 1179-1349. ; 13, s. 1141-1153
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https://doi.org/10.2...
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https://umu.diva-por... (primary) (Raw object)
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Abstract
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- Purpose: Evidence is insufficient to infer whether topical calcineurin inhibitors (TCIs; tacrolimus and pimecrolimus) cause malignancy. The study objective was to estimate the long-term risk of skin cancer and lymphoma associated with topical TCI use in adults and children, separately.Patients and Methods: A cohort study in Denmark, Sweden, UK, and the Netherlands was conducted. Adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated for nonmelanoma skin cancer (NMSC), melanoma, cutaneous T-cell lymphoma (CTCL), non-Hodgkin lymphoma (NHL) excluding CTCL, and Hodgkin lymphoma (HL) in new users of TCIs versus users of moderate/high-potency topical corticosteroids.Results: The study included 126,908/61,841 adults and 32,605/27,961 children initiating treatment with tacrolimus/pimecrolimus, respectively. Follow-up was ≥10 years for 19% of adults and 32% of children. Incidence rate ratios and (95% confidence intervals) for tacrolimus versus corticosteroid users in adults were <1 for melanoma, non-Hodgkin lymphoma, and Hodgkin lymphoma; and 1.80 (1.25-2.58) for cutaneous T-cell lymphoma. For pimecrolimus, IRRs in adults were <1 for non-Hodgkin lymphoma, cutaneous T-cell lymphoma, and Hodgkin's lymphoma; and 1.21 (1.03-1.41) for melanoma; and 1.28 (1.20-1.35) for nonmelanoma skin cancer. In children, results were inconclusive due to few events. In adults, incidence rate ratios ≥5 years after first topical calcineurin inhibitor exposure were not higher than in overall analyses.Conclusion: Overall, we found little evidence associating use of topical calcineurin inhibitors with skin cancer and lymphoma; confounding by indication, surveillance bias, and reverse causation may have influenced these results. Even if causal, the public health impact of these excess risks would be low and confined to the first years of exposure.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)
Keyword
- cutaneous T-cell lymphoma
- database study
- malignant melanoma
- non-melanoma skin cancer
- pimecrolimus
- tacrolimus
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Arana, Alejandro
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Pottegård, Anton
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Kuiper, Josephin ...
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Booth, Helen
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Reutfors, Johan
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Calingaert, Bria ...
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show more...
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Lund, Lars Chris ...
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Crellin, Elizabe ...
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Schmitt-Egenolf, ...
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Kaye, James A.
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Gembert, Karin
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Rothman, Kenneth ...
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Kieler, Helle
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Dedman, Daniel
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Houben, Eline
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Gutiérrez, Lia
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Hallas, Jesper
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Perez-Gutthann, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Dermatology and ...
- Articles in the publication
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Clinical Epidemi ...
- By the university
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Umeå University
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Karolinska Institutet