Are you taking an ARB (such as Cozaar and similar prescriptions)?

[tobagotwo]

From a recent FDA notice. Please be aware that they are not saying that it increases cancer risk at this time, but are noting that there is some early data to be aware of.

Angiotensin Receptor Blockers (ARBs): Ongoing Safety Review for Cancer Risk
AUDIENCE: Cardiology, Oncology, Family Practice

ISSUE: A recently published study - a meta-analysis combining cancer-related findings from several clinical trials - suggested use of ARBs may be associated with a small increased risk of cancer.

BACKGROUND: ARBs are used in patients with high blood pressure and other conditions. Brand names include Atacand, Avapro, Benicar, Cozaar, Diovan, Micardis, and Teveten.

The meta-analysis included data from over 1,000 patients in several long-term, randomized, controlled clinical trials evaluating ARBs for which adverse events related to cancer were captured during the study. The mean duration of follow-up ranged from 1.7 to 4.8 years.

The study reported the frequencies of new cancer occurrence to be 7.2% for patients receiving ARBs compared to 6.0% for those not receiving ARBs (risk ratio = 1.08, 95% Confidence Interval: 1.01-1.15). No statistically significant difference in cancer deaths was noted.

RECOMMENDATION: FDA has not concluded that ARBs increase the risk of cancer. The Agency is reviewing information related to this safety concern and will update the public when additional information is available. FDA believes the benefits of ARBs continue to outweigh their potential risks.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

Online: www.fda.gov/MedWatch/report.htm
Phone: 1-800-332-1088
Mail: return the postage-paid FDA form 3500, which may be downloaded from the MedWatch "Download Forms" page, to address on the pre-addressed form
Fax: 1-800-FDA-0178
Read the MedWatch safety alert page, including a link to the Drug Safety Communication, at:

http://www.fda.gov/Safety/MedWatch/...tyAlertsforHumanMedicalProducts/ucm219185.htm

Again, this is not a panic situation at all, and just means you should reassess your own perceived risk.

Best wishes,

 

[Jkm7]

Is this considered a tiny additional risk, small, moderate, significant? I don't know how to 'translate' the percentage to perceived level of risk.
I don't take any ARB's but a family member does.
Thanks.

 

[Ross]

Is this considered a tiny additional risk, small, moderate, significant? I don't know how to 'translate' the percentage to perceived level of risk.
I don't take any ARB's but a family memer does.
Thanks.

Here again, we are listening to statistics and in their own words:

No statistically significant difference in cancer deaths was noted.

They are simply stating that there is a possibility that it may increase your risks for cancer. It would be nice if they could put a finger on exactly what does cause cancer. I'm convinced that we are all born with it, but at some point in time, either the bomb does or does not go off.

 

[Lily]

Bob - Thank you very much for this information

I've been on two of them, not at the same time, for the last six years :eek2:

Something else to address with my cardio next visit I guess.

 

[kpearse]

Oh goody something else to think about.

 

[AgilityDog]

Lies, Damned Lies, and Statistics.

Maybe there's a link but ACE inhibitors give me migraines. Daily. I'll keep my ARB.

I figure my heart will kill me before any cancer does, and if I get cancer, my heart won't likely tolerate the chemos anyway.

 

[Maryka]

I am still following Hal Dietz, MD, and his personal/professional advice to me: I am still taking my generic Cozaar.

 

[ottagal]

Thanks for this info Bob. As noted, this is not something to panic about, but good to be cognizant of.

 

[drivetopless]

I love my cozaar. Hmm. Thanks for the info, though.

 

[Lily]

Actually, I was on Diovan for years before my valve replacement surgery and it's one of these types too. H-m-m-m.

 

[Bill B]

From a recent FDA notice. Please be aware that they are not saying that it increases cancer risk at this time, but are noting that there is some early data to be aware of. Again, this is not a panic situation at all, and just means you should reassess your own perceived risk.

(risk ratio = 1.08, 95% Confidence Interval: 1.01-1.15).

Bob's precautions are key. The confidence interval just missed including 1.0 (null, no increase) by the thinnest hair. Maybe a few cancer diagnoses different and we would never have heard about this. I'd like to see the results broken out by source. The results are "pooled" from a bunch of different trials and there might be one outlier pushing the average. I'd like to see the kinds of cancer that were involved too. Regardless, I see this as a very, very small risk ratio.

 

[Nancy]

I remember when I first started Simvastatin. I had just gone through treatment for breast cancer, and there were reports about that causing cancer, I don't think it was a major problem, but was reported anyway. So when I had an appt. with the oncologist I asked him about it, and he became very philosophical and told me that every drug had side effects, and many of them could have a slim chance of causing cancer, and that reporters report even the smallest percentages because cancer information sells. He said that you have to look at the great benefits of the drug against the slim chances of it causing some kind of cancer, and that might never happen.

So, I am still on Simvastatin and I am also on Cozaar. Both drugs have made a major change for the better in my life.

And BTW, cancer treatments themselves also have a slim chance of causing cancer. How ironic.

 

[tobagotwo]

This ain't nothin' compared to beta blockers, which can cause autoimmune diseases and diabetes (why the British use ACE inhibitors as their first line of attack instead). All types of blood pressure drugs intrerfere with renin production or use. Beta blockers, ACE inhibitors and Calcium Channel blockers contain chemicals that bind with other chemicals in the renin processes (renin is produced in the kidneys, which require excellent blood flow to work). All are described as "nonspecific" in their action, meaning that the chemicals tend to also get involved with a lot of other body chemicals that have nothing to do with blood pressure.

This is why it's so important to keep trying different brands if you're uncomfortable. Each is different and can affect different things. Keep trying until you feel comfortable with your medication. As your body chemistry is unique, what works for your friend may not work well for you.

By the way, I'm on a beta blocker and an ACE inhibitor. But it's doing a good job with my blood pressure, and isn't affecting me overtly otherwise. At some point, you have to determine which is the greater threat and live with the lesser of the evils.

Best wishes,