Association of Vitamin K and Non-Vitamin K Oral Anticogulant Use And Cancer Incidence In Atrial Fibrillation Patients

Clin Pharmacol Ther. 2021 Jul 9. doi: 10.1002/cpt.2362. Online ahead of print.ABSTRACTThe association between the use of Vitamin K antagonists (VKA) and cancer risk reduction remains unclear. We aimed to assess the association between the use of VKA or DOAC and the incidence of cancer in a large cohort of AF patients by meaans of a population-based, propensity-weighted cohort study using population-wide databases including patients diagnosed with non-valvular AF (NVAF) followed for up of 5 years (median 2.94 years). We created two cohorts based on the initiation therapy (VKA or DOAC). Initiation with VKA or DOAC was defined as filling a prescription with no previous exposure in the preceding 12 months. Cancer diagnoses of any type and for specific tumours (lung, colon, prostate, bladder, breast). We included 39,989 patients, 31,200 (78.0%) in the VKA cohort. Incidence rate for any cancer was 12.45 per 1000 person-year in the DOAC cohort, vs. 14.55 in the VKA cohort (adjusted HR: 1.16, 95% CI: 1.02-1.32). In secondary outcomes, no differences were found for specific types of cancer such as lung (HR: 1.28, CI: 0.89-1.83), colon (HR: 0.84, CI: 0.62-1.13), prostate (HR: 1.40, CI: 0.94-2.10), bladder (HR: 1.07, CI: 0.76-1.52), breast (HR: 1.05, CI: 0.66-1.69). Sensitivity analyses yielded similar results. Subgroup analyses also produced consistent findings, except for men, for whom VKA was associated with a lower risk of colon cancer (HR: 0.68; 95%CI: 0.48-0.96). Our results do no...
Source: Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Authors: Source Type: research