TY - JOUR
T1 - Selective serotonin reuptake inhibitors use and hepatocellular carcinoma in patients with alcohol use disorder
AU - Chen, Vincent Chin Hung
AU - Lee, Min Jing
AU - Yang, Yao Hsu
AU - Lu, Mong Liang
AU - Chiu, Wei Che
AU - Dewey, Michael E.
N1 - Funding Information:
This study was supported by Chang Gung Medical Foundation , Chiayi Chang Gung Memorial Hospital and Chang Gung University, Chiayi, Taiwan ( CORPG6G0101 , CORPG6G0102 , CORPG6G0103 , CORPG6G0161 , CORPG6G0162 , CORPG6G0163 ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2020 Elsevier B.V.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Background: Research has proposed that selective serotonin reuptake inhibitors (SSRIs) were associated with a reduction of the risk of hepatocellular carcinoma (HCC). The objective of this study is to investigate whether SSRIs use is associated with decreased risk of HCC in patients with alcohol use disorder (AUD). Patients and methods: We conducted a retrospective population-based cohort study using Taiwan's National Health Insurance Research Database (NHIRD) from 1997 to 2013 and enrolled patients with newly diagnosed AUD. After propensity scores matching at a ratio 1:4, total of 4945 SSRI users and 19,785 non-SSRI users were included in the matched cohort. Patients were followed up from the 365th day after the date of first exposure to SSRIs to occurrence of HCC, the date of death, or the end of 2013. Cox proportional hazard regressions were performed to evaluate hazard ratio (HRs) for HCC in SSRI-exposed patients compared with unexposed patients. Results: In the main study cohort, SSRI use was associated with significant lower risk of HCC compared to the non-SSRI users after adjusting for age, sex, income, urbanization, alcoholic fatty liver, alcoholic hepatitis and diabetes (adjusted hazard ratio [aHR] = 0.31, 95 % CI = 0.24−0.39). The negative association of SSRI use and HCC was replicated in the matched cohort (aHR = 0.58, 95 % CI = 0.44−0.77). The effect of SSRI use on HCC was dose-related in both cohorts (p for trend < 0.0001). Conclusions: This study showed that SSRIs use was associated with a reduction risk of HCC among AUD patients in a cumulative dose effect manner.
AB - Background: Research has proposed that selective serotonin reuptake inhibitors (SSRIs) were associated with a reduction of the risk of hepatocellular carcinoma (HCC). The objective of this study is to investigate whether SSRIs use is associated with decreased risk of HCC in patients with alcohol use disorder (AUD). Patients and methods: We conducted a retrospective population-based cohort study using Taiwan's National Health Insurance Research Database (NHIRD) from 1997 to 2013 and enrolled patients with newly diagnosed AUD. After propensity scores matching at a ratio 1:4, total of 4945 SSRI users and 19,785 non-SSRI users were included in the matched cohort. Patients were followed up from the 365th day after the date of first exposure to SSRIs to occurrence of HCC, the date of death, or the end of 2013. Cox proportional hazard regressions were performed to evaluate hazard ratio (HRs) for HCC in SSRI-exposed patients compared with unexposed patients. Results: In the main study cohort, SSRI use was associated with significant lower risk of HCC compared to the non-SSRI users after adjusting for age, sex, income, urbanization, alcoholic fatty liver, alcoholic hepatitis and diabetes (adjusted hazard ratio [aHR] = 0.31, 95 % CI = 0.24−0.39). The negative association of SSRI use and HCC was replicated in the matched cohort (aHR = 0.58, 95 % CI = 0.44−0.77). The effect of SSRI use on HCC was dose-related in both cohorts (p for trend < 0.0001). Conclusions: This study showed that SSRIs use was associated with a reduction risk of HCC among AUD patients in a cumulative dose effect manner.
KW - Alcohol use disorder
KW - Depression
KW - Dose effect
KW - Hepatocellular carcinoma
KW - Selective serotonin reuptake inhibitor
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U2 - 10.1016/j.drugalcdep.2020.108495
DO - 10.1016/j.drugalcdep.2020.108495
M3 - Article
AN - SCOPUS:85099211531
SN - 0376-8716
VL - 219
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 108495
ER -