Skin cancer associated with commonly prescribed drugs: tumor necrosis factor alpha inhibitors (TNF-αIs), angiotensin-receptor blockers (ARBs), phosphodiesterase type 5 inhibitors (PDE5Is) and statins -weighing the evidence

Expert Opin Drug Saf. 2018 Feb;17(2):139-147. doi: 10.1080/14740338.2018.1400530. Epub 2017 Nov 8.

Abstract

Introduction: Skin cancers, including both malignant melanoma (MM) and nonmelanoma skin cancer (NMSC), are the most commonly diagnosed cancers in the US. The incidence of both MM and NMSC continues to rise.

Areas covered: Current evidence for an association between four of the most commonly prescribed classes of drugs in the U.S. and risk for MM and NMSC is reported. Medline was searched (January 2000 to May 2017) for each drug in the classes and for 'basal cell carcinoma', 'squamous cell carcinoma', 'non-melanoma skin cancer', 'skin cancer' and 'melanoma'. Skin cancer risk information was reported for: tumor necrosis factor alpha inhibitors (TNF-αIs), angiotensin-receptor blockers (ARBs), phosphodiesterase type 5 inhibitors (PDE5Is) and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA)-reductase inhibitors (statins).

Expert opinion: Since skin cancer risk is associated with all four classes of these commonly prescribed drugs that represent nearly 20% of the Top 100 drugs in the U.S., these important findings warrant enhanced education, especially for prescribers and those patients at high risk for skin cancer.

Keywords: HMG-CoA-reductase inhibitors; Tumor necrosis factor alpha inhibitors; angiotensin-receptor blockers; basal cell carcinoma; melanoma; non-melanoma skin cancer; phosphodiesterase type 5 inhibitors; skin cancer; squamous cell carcinoma; statins.

Publication types

  • Review

MeSH terms

  • Angiotensin Receptor Antagonists / adverse effects
  • Carcinoma, Basal Cell / chemically induced
  • Carcinoma, Basal Cell / epidemiology
  • Carcinoma, Squamous Cell / chemically induced
  • Carcinoma, Squamous Cell / epidemiology
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Incidence
  • Melanoma / chemically induced*
  • Melanoma / epidemiology
  • Phosphodiesterase 5 Inhibitors / adverse effects
  • Skin Neoplasms / chemically induced*
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / pathology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Angiotensin Receptor Antagonists
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Phosphodiesterase 5 Inhibitors
  • Tumor Necrosis Factor-alpha