Sotalol & Digoxin (antiarrhythmic drugs) & PCa.

[pjoshea13]

New study below [4].

The PCa literature consists of 4 studies using data from Finland.

"Sotalol is a non-selective competitive beta-adrenergic receptor blocker that also exhibits Class III antiarrhythmic properties." [5]

"Digoxin, sold under the brand name Lanoxin among others, is a medication used to treat various heart conditions. Most frequently it is used for atrial fibrillation, atrial flutter, and heart failure." [6]

[1] It starts in 2015:

"Compared to never-users of antiarrhythmic drugs, we found no significant association between digoxin use and prostate cancer risk overall [odds ratio (OR) 0.95 ...] or for advanced prostate cancer risk (OR: 0.90 ...). The result was similar also for other antiarrhythmic drugs, with the exception of sotalol, users of which had decreased risk of advanced prostate cancer (OR: 0.73 ...). Also the overall prostate cancer risk decreased by duration of sotalol use ..."

[2] (2016):

"Long-term usage of the antiarrhythmic drug digoxin has been connected to lowered risk of prostate cancer. A recent study has suggested that beta-blockers might also have similar risk-decreasing effects. We evaluated the association between use of digoxin, beta-blocker sotalol, and other antiarrhythmic drugs and prostate cancer risk in a retrospective cohort study."

"No association was found for overall prostate cancer risk with antiarrhythmic drug use (HR 1.05 ...). Neither sotalol (HR 0.97 ...) nor digoxin (HR 1.01 ...) users had a decreased risk of prostate cancer. Similar results were obtained for high-grade (Gleason 7-10) and metastatic prostate cancer. Nevertheless, the risk estimates for Gleason 7-10 prostate cancer tended to decrease by duration of digoxin use .., suggesting that the drug may reduce the risk in long-term usage (HR 0.71...). In analysis stratified by screening trial arm, the protective association against Gleason 7-10 disease was observed only in the screening arm (HR 0.31 ... for men who had used digoxin for 5 years or longer)."

[3] (2016)

"No association was found for prostate cancer death with digoxin usage before (HR 1.00 ...) or after (HR 0.81 ...) prostate cancer diagnosis. The results were also comparable for sotalol and antiarrhythmic drugs in general. Among men not receiving hormonal therapy, prediagnostic digoxin usage was associated with prolonged prostate cancer survival (HR 0.20 ...)."

[4] (2018):

"During the median follow-up of 17.0 years after the baseline 28,936 (36.8%) men died, of these 8,889 due to cancer. 9,023 men (11.5%) had used antiarrhythmic drugs. Overall cancer mortality was elevated among antiarrhythmic drug users compared to non-users (HR 1.43 ...). Similar results were observed separately for digoxin and for sotalol. However, the risk associations disappeared in long-term use and were modified by background co-morbidities. All in all, cancer mortality was elevated among antiarrhythmic drug users. This association is probably non-causal as it was related to short-term use and disappeared in long-term use."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/256...

[2] ncbi.nlm.nih.gov/pubmed/265...

[3] ncbi.nlm.nih.gov/pubmed/277...

[4] ncbi.nlm.nih.gov/pubmed/299...

Sci Rep. 2018 Jul 9;8(1):10308. doi: 10.1038/s41598-018-28541-4.

Cancer mortality does not differ by antiarrhythmic drug use: A population-based cohort of Finnish men.

Kaapu KJ1, Rantaniemi L2, Talala K3, Taari K4, Tammela TLJ2,5, Auvinen A6, Murtola TJ2,5.

Author information

1

University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland. [e-mail].

2

University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland.

3

Finnish Cancer Registry, Helsinki, Finland.

4

University of Helsinki and Helsinki University Hospital, Department of Urology, Helsinki, Finland.

5

Tampere University Hospital, Department of Urology, Tampere, Finland.

6

University of Tampere, School of Health Sciences, Tampere, Finland.

Abstract

In-vitro studies have suggested that the antiarrhythmic drug digoxin might restrain the growth of cancer cells by inhibiting Na+/K+-ATPase. We evaluated the association between cancer mortality and digoxin, sotalol and general antiarrhythmic drug use in a retrospective cohort study. The study population consists of 78,615 men originally identified for the Finnish Randomized Study of Screening for Prostate Cancer. Information on antiarrhythmic drug purchases was collected from the national prescription database. We used the Cox regression method to analyze separately overall cancer mortality and mortality from the most common types of cancer. During the median follow-up of 17.0 years after the baseline 28,936 (36.8%) men died, of these 8,889 due to cancer. 9,023 men (11.5%) had used antiarrhythmic drugs. Overall cancer mortality was elevated among antiarrhythmic drug users compared to non-users (HR 1.43, 95% CI 1.34-1.53). Similar results were observed separately for digoxin and for sotalol. However, the risk associations disappeared in long-term use and were modified by background co-morbidities. All in all, cancer mortality was elevated among antiarrhythmic drug users. This association is probably non-causal as it was related to short-term use and disappeared in long-term use. Our results do not support the anticancer effects of digoxin or any other antiarrhythmic drug.

PMID: 29985440 DOI: 10.1038/s41598-018-28541-4

...

[5] en.wikipedia.org/wiki/Sotalol

[6] en.wikipedia.org/wiki/Digoxin