Use of drugs for hyperlipidaemia and diabetes and risk of primary and secondary brain tumours: nested case-control studies using the UK Clinical Practice Research Datalink (CPRD)

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Abstract

Objectives: Previous studies have suggested that fibrates and glitazones may have a role in brain tumour prevention. We examined if there is support for these observations using primary care records from the UK Clinical Practice Research Datalink (CPRD).

Design: We conducted two nested case-control studies using primary and secondary brain tumours identified within CPRD between 2000 to 2016. We selected cases and controls amongst the population of individuals who had been treated with any anti-diabetic or anti-hyperlipidaemic medication to reduce confounding by indication.

Setting: Adults older than 18 years registered with a General Practitioner in the UK contributing data to CPRD.

Results: We identified 7,496 people with any brain tumour (4,471 primary; 3,025 secondary)in total. After restricting cases and controls to those prescribed any anti-diabetic or anti-hyperlipidaemic medication, there were 1,950 cases and 7,791 controls in the fibrate and 480 cases with 1,920 controls in the glitazone analyses. Longer use of glitazones compared to all other anti-diabetic medications was associated with a reduced risk of primary (adjusted odds ratio [aOR] = 0.89 per year, 95% CI: 0.80, 0.98), secondary (aOR = 0.87 per year, 95% CI: 0.77, 0.99) or combined brain tumours (aOR = 0.88 per year, 95% CI: 0.81, 0.95). There was little evidence that fibrate exposure was associated with risk of either primary or secondary brain tumours.
Original languageEnglish
Article numbere072026
Pages (from-to)1-9
Number of pages9
JournalBMJ Open
Volume14
Issue number2
Early online date9 Feb 2024
DOIs
Publication statusPublished - 30 Mar 2024

Bibliographical note

Funding Information:
JWR receives funding from Biogen for unrelated research. All other authors declare no conflicts of interest.

Funding Information:
The Medical Research Council (MRC)/University of Bristol Integrative Epidemiology Unit (IEU) is supported by the MRC and the University of Bristol (MC_UU_12013/1, MC_UU_12013/2). JWR is supported by a joint studentship from NHS Southmead Hospital Charity (SOCS/SJ1447). RMM is supported by a Cancer Research UK (CRUK) Programme Grant, the Integrative Cancer Epidemiology Programme (C18281/A29019). JWR and RMM are members of the MRC IEU which is supported by the MRC and the University of Bristol (MC_UU_12013/1-9). RMM is supported by the National Institute for Health Research (NIHR) Bristol Biomedical Research Centre which is funded by the NIHR and is a partnership between University Hospitals Bristol NHS Trust and Weston NHS Foundation Trust and the University of Bristol. RMM is a NIHR Senior Investigator (NIHR202411). This work was supported by funding from the Brain Tumour Bank and Research Fund, Southmead Hospital Charity (Registered Charity Number: 1055900), and University of Bristol Campaigns and Alumni funding. This work was supported by CRUK (Grant Number: C18281/A29019), as part of the Integrative Cancer Epidemiology Programme. MTR, MMCE and YBS are supported by the NIHR Applied Research Collaboration West (NIHR ARC West) (YB-S also receives HEFCE funding). The views expressed in this article are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Funding Information:
The Medical Research Council (MRC)/University of Bristol Integrative Epidemiology Unit (IEU) is supported by the MRC and the University of Bristol (MC_UU_12013/1, MC_UU_12013/2). JWR is supported by a joint studentship from NHS Southmead Hospital Charity (SOCS/SJ1447). RMM is supported by a Cancer Research UK (CRUK) Programme Grant, the Integrative Cancer Epidemiology Programme (C18281/A29019). JWR and RMM are members of the MRC IEU which is supported by the MRC and the University of Bristol (MC_UU_12013/1-9). RMM is supported by the National Institute for Health Research (NIHR) Bristol Biomedical Research Centre which is funded by the NIHR and is a partnership between University Hospitals Bristol NHS Trust and Weston NHS Foundation Trust and the University of Bristol. RMM is a NIHR Senior Investigator (NIHR202411). This work was supported by funding from the Brain Tumour Bank and Research Fund, Southmead Hospital Charity (Registered Charity Number: 1055900), and University of Bristol Campaigns and Alumni funding. This work was supported by CRUK (Grant Number: C18281/A29019), as part of the Integrative Cancer Epidemiology Programme. MTR, MMCE and YBS are supported by the NIHR Applied Research Collaboration West (NIHR ARC West) (YB-S also receives HEFCE funding). The views expressed in this article are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Funding Information:
We used the CPRD database which contains data from a network of over 2000 general practitioners (GPs) from more than 670 practices across the UK. Validated clinical information is held on over 16 million registered patients, amounting to circa 7% of the UK population and broadly representative of that population. Types of data held within the CPRD include, but are not limited to, patient demographics, referrals, hospital admissions, clinical diagnoses and drug prescriptions. Data from secondary care or hospital visits are routinely fed back into the electronic records’ system via staff at GP practices. CPRD is jointly sponsored by the Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute of Health Research (NIHR). Data were extracted from CPRD GOLD and linked to Office for National Statistics (ONS) death registration data and census data on area deprivation (see later).

Publisher Copyright:
© Author(s) (or their employer(s)) 2024.

Structured keywords

  • ICEP

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