• John Evans

TCIs do not raise keratinocyte carcinoma risk

A study of nearly 94,000 U.S. adults with atopic dermatitis (AD) has found no elevated risk of keratinocyte carcinomas (KCs) in individuals treated with topical calcineurin inhibitors (TCIs), compared to those treated with topical steroids.

Published online ahead of print in JAMA Dermatology (Aug. 12, 2020), the retrospective cohort study was conducted to examine KC risk overall and by subtype among adults with AD exposed to TCIs compared with those exposed to topical corticosteroids and those who had not been exposed to either treatment. The investigators also look at whether TCI dose, frequency or duration of exposure impacted risk.

“I thought that the data implicating increased skin cancer risk with TCIs was not robust, and that prompted me to get involved in studying it,” lead author Dr. Maryam M. Asgari said in a press release. Dr. Asgari is an investigator in the Department of Dermatology at Massachusetts General Hospital in Boston.

Investigators found no association between TCI use and risk for either KCs overall, or for squamous cell or basal cell carcinomas individually. That did not change when they looked at different doses, frequency and duration of TCI use.

“We analyzed the data with multiple sensitivity analyses to explore the association of TCI use and skin cancer risk in detail, which revealed no association each time, so that was very reassuring,” Dr. Asgari said.

The study used data from Kaiser Permanente Northern California in Oakland, Calif. This included integrated pharmacy and pathology data on 93,746 adults aged 40 years and older who were diagnosed by a clinician with atopic dermatitis or dermatitis from Jan. 2002 through Dec. 2013.


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