Spironolactone use does not increase the risk of female breast cancer recurrence: A retrospective analysis.

Abstract

BACKGROUND:

Spironolactone is used off-label for androgenic alopecia because of its ability to arrest hair loss progression and long-term safety profile. However, little is known about the safety of spironolactone in breast cancer (BC) survivors. Because spironolactone has estrogenic effects, there is a theoretical risk for BC recurrence. Given that spironolactone is an important tool in the treatment of alopecia, we investigated whether spironolactone increased risk for BC recurrence.

OBJECTIVE:

To determine whether spironolactone is associated with increased BC recurrence.

METHODS:

A retrospective analysis was conducted using the Humana Insurance database. Patients with a history of BC were identified using International Classification of Diseases codes, stratified by spironolactone prescription, and also matched 1:1 using propensity score analysis. Patient characteristics and cancer recurrence rates between both cohorts were compared and analyzed.

RESULTS:

BC recurrence developed in 123 patients (16.5%) who were prescribed spironolactone compared with 3649 patients (12.8%) who developed BC recurrence without spironolactone prescribed (P = .004). After propensity matching, adjusted Cox regression analysis showed no association between spironolactone and increased BC recurrence (adjusted hazard ratio, 0.966; 95% confidence interval, 0.807-1.156; P = .953).

LIMITATIONS:

Retrospective study.

CONCLUSION:

Spironolactone was not independently associated with increased BC recurrence and may be considered for the treatment of alopecia in BC survivors.

• Authors: Chapman Wei, Patawut Bovonratwet, Alex Gu, Gaby Moawad, Jonathan I Silverberg, Adam J Friedman
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 83 Issue 4 Pg. 1021-1027 (10 2020) ISSN: 1097-6787 [Electronic] United States
• PMID: 32446820 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Mineralocorticoid Receptor Antagonists
• Spironolactone

Topics

• Adult
• Aged
• Aged, 80 and over
• Alopecia (drug therapy)
• Breast Neoplasms (epidemiology, pathology)
• Databases, Factual
• Female
• Humans
• Middle Aged
• Mineralocorticoid Receptor Antagonists (therapeutic use)
• Neoplasm Recurrence, Local (epidemiology)
• Off-Label Use (statistics & numerical data)
• Propensity Score
• Proportional Hazards Models
• Risk Factors
• Spironolactone (therapeutic use)
• United States (epidemiology)
• Young Adult