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)

Jamie W Robinson; Richard M Martin; Mio Ozawa; Martha M C Elwenspoek; Maria Theresa Redaniel; Kathreena M Kurian; Yoav Ben-Shlomo

doi:10.1136/bmjopen-2023-072026

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)

Jamie W Robinson, Richard M Martin, Mio Ozawa, Martha M C Elwenspoek, Maria Theresa Redaniel, Kathreena M Kurian, Yoav Ben-Shlomo^*

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

1 Citation (Scopus)

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 language	English
Article number	e072026
Pages (from-to)	1-9
Number of pages	9
Journal	BMJ Open
Volume	14
Issue number	2
Early online date	9 Feb 2024
DOIs	https://doi.org/10.1136/bmjopen-2023-072026
Publication status	Published - 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.

Research Groups and Themes

ICEP

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1136/bmjopen-2023-072026Licence: CC BY

Handle.net

Persistent link

8074 (C18281/A29019) ICEP2 - Programme Award: Towards improved casual evidence and enhanced prediction of cancer risk and survival
Martin, R. M. (Principal Investigator)
1/10/20 → 30/09/25
Project: Research

Cite this

Robinson, J. W., Martin, R. M., Ozawa, M., Elwenspoek, M. M. C., Redaniel, M. T., Kurian, K. M., & Ben-Shlomo, Y. (2024). 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). BMJ Open, 14(2), 1-9. Article e072026. https://doi.org/10.1136/bmjopen-2023-072026

@article{84c7f8945a3345339e19f0030cd31786,

title = "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)",

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.",

author = "Robinson, {Jamie W} and Martin, {Richard M} and Mio Ozawa and Elwenspoek, {Martha M C} and Redaniel, {Maria Theresa} and Kurian, {Kathreena M} and Yoav Ben-Shlomo",

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{\textquoteright} 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: {\textcopyright} Author(s) (or their employer(s)) 2024.",

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month = mar,

day = "30",

doi = "10.1136/bmjopen-2023-072026",

language = "English",

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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). / Robinson, Jamie W; Martin, Richard M; Ozawa, Mio et al.
In: BMJ Open, Vol. 14, No. 2, e072026, 30.03.2024, p. 1-9.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - Use of drugs for hyperlipidaemia and diabetes and risk of primary and secondary brain tumours

T2 - nested case-control studies using the UK Clinical Practice Research Datalink (CPRD)

AU - Robinson, Jamie W

AU - Martin, Richard M

AU - Ozawa, Mio

AU - Elwenspoek, Martha M C

AU - Redaniel, Maria Theresa

AU - Kurian, Kathreena M

AU - Ben-Shlomo, Yoav

N1 - 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.

PY - 2024/3/30

Y1 - 2024/3/30

N2 - 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.

AB - 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.

U2 - 10.1136/bmjopen-2023-072026

DO - 10.1136/bmjopen-2023-072026

M3 - Article (Academic Journal)

C2 - 38336454

SN - 2044-6055

VL - 14

SP - 1

EP - 9

JO - BMJ Open

JF - BMJ Open

IS - 2

M1 - e072026

ER -

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)

Abstract

Bibliographical note

Research Groups and Themes

UN SDGs

Access to Document

Handle.net

Fingerprint

Projects

8074 (C18281/A29019) ICEP2 - Programme Award: Towards improved casual evidence and enhanced prediction of cancer risk and survival

Cite this