Presenting Author:

Fatima Sozzer

Principal Investigator:

Beatrice Nardone

Department:

Dermatology

Keywords:

Pharmacovigilance, tetracyclines, non-melenoma skin cancer

Location:

Ryan Family Atrium, Robert H. Lurie Medical Research Center

C17 - Clinical

Tetracyclines and Association with Subsequent Non-Melanoma Skin Cancer

Introduction Tetracyclines (TCN) are commonly used in the management of chronic dermatologic disorders, in part due to their affinity for inflamed skin tissue. These agents are known photosensitizers, and ultraviolet radiation exposure subsequent to skin photosensitization has been shown to increase photodamage, which may increase the risk of skin cancer. However, minimal evidence examining an association between chronic TCN exposure and subsequent non-melanoma skin cancer (NMSC) exists. The aim of this study was to explore the possibility of such association in a large Midwestern U.S. patient population. Methods The Northwestern Medicine Enterprise Data Warehouse repository was searched to detect data for adult patients aged 18-90 years old who received at least 12 consecutive months of oral doxycycline (D), minocycline (M), or tetracycline (T), and at least 12 months of in-person physician follow-up after drug initiation. This TCN-exposed cohort was compared to a control population consisted of non-exposed patients within the same data repository. A subsequent diagnosis of NMSC (basal cell carcinoma or squamous cell carcinoma) occurring at least 12 months after TCN exposure was detected by use of ICD-9 codes (173.0-173.9). An odds ratio (OR) was obtained using logistic regression analyses after adjusting for age, gender, and race. Results Patient data for the period January 1, 2001 to September 6, 2016 were detected and examined for a total of 826,870 individuals (mean age = 50.8 years, 62% female, 55% Caucasian, 11% African-American). Of these, 1,800 patients had > 12 months of TCN exposure (median 17 ± 27.2 months), of which 36 had a subsequent diagnosis of NMSC (median time to diagnosis of 39 ± 23.8 months). A significant increased risk for NMSC was demonstrated for those who had chronic TCN exposure compared to those who had no TCN exposure (adjusted OR: 1.73; 95% CI 1.24-2.42). There was no significant difference between D, M, or T in the association with NMSC (p=0.473, p=0.582, p=0.717, respectively). Conclusions As a class (tetracycline, doxycycline, and minocycline), chronic exposure (> 12 months) to a TCN and association with subsequent NMSC warrants further exploration in order to better determine the potential implications for therapeutic decision-making, particularly for those patients at increased risk for NMSC.