Phosphodiesterase type 5 inhibitors and risk of melanoma: A meta-analysis

• Published in: Journal of the American Academy of Dermatology 2017-09, Vol.77 (3), p.480-488.e9
• Main Authors: Tang, Huilin, Wu, Wenting, Fu, Shuangshuang, Zhai, Suodi, Song, Yiqing, Han, Jiali
• Format: Article
• Language: English
• Subjects: basal cell carcinoma; Humans; melanoma; Melanoma - chemically induced; Melanoma - epidemiology; meta-analysis; Observational Studies as Topic; PDE5 inhibitor; Phosphodiesterase 5 Inhibitors - adverse effects; Risk Factors; Skin Neoplasms - chemically induced; Skin Neoplasms - epidemiology; squamous cell carcinoma
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2017.04.1129

The association between phosphodiesterase type 5 (PDE5) inhibitors and melanoma risk is controversial. We quantify the association between use of PDE5 inhibitors and melanoma. We systematically searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov for studies that were conducted up to July 13, 2016, and evaluated the association between PDE5 inhibitors and skin cancer. Random effects meta-analyses were used to calculate the adjusted odds ratio (OR) with the 95% confidence interval (CI). Five observational studies were included. Compared with PDE5 inhibitor nonuse, PDE5 inhibitor use was slightly but significantly associated with an increased risk for development of melanoma (OR, 1.12; 95% CI, 1.03-1.21) and basal cell carcinoma (OR, 1.14; 95% CI, 1.09-1.19) but not squamous cell carcinoma. For melanoma risk, none of the prespecified factors (dose of PDE5 inhibitor, study design, and study region) significantly affected the results (P > .05). Our sensitivity analysis confirmed the stability of the results. We included only observational studies, which had some heterogeneities and inconsistent controlling for potential confounders. Use of PDE5 inhibitors may be associated with a slightly increased risk for development of melanoma and basal cell carcinoma but not squamous cell carcinoma. However, further large well-conducted prospective studies with adequate adjustment for potential confounders are required for confirmation.