title: Use of cardiac glycosides and risk of glioma.
abstract: Cardiac glycosides induce apoptotic effects on glioma cells, but whether cardiac glycosides protect against risk for glioma is unknown. We therefore explored the relation between glycoside use and glioma risk using a large and validated database. We performed a case-control analysis using the Clinical Practice Research Datalink involving 2005 glioma cases diagnosed between 1995 and 2012 that were individually matched to 20,050 controls on age, gender, general practice, and number of years of active history in the database. Conditional logistic regression analysis was used to evaluate the association between cardiac glycosides and the risk of glioma adjusting for body mass index and smoking. We also examined use of common heart failure and arrhythmia medications to differentiate between a specific glycoside effect and a generic effect of treatment for congestive heart failure or arrhythmia. Cardiac glycoside use was inversely related to glioma incidence. After adjustment for congestive heart failure, arrhythmia, diabetes, and common medications used to treat those conditions, the OR of glioma was 0.47 (95% CI 0.27-0.81, Bonferroni-corrected p value = 0.024) for use versus non-use of cardiac glycosides, based on 17 exposed cases. In contrast, no associations were noted for other medications used to treat congestive heart failure or arrhythmias. The OR of glioma in people with congestive heart failure was 0.65 (95% CI 0.40-1.04), and for arrhythmia it was 1.01 (95% CI 0.78-1.31). These data indicate that cardiac glycoside use is independently associated with reduced glioma risk.
authors.affiliation: Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. corinna.seliger@klinik.uni-regensburg.de.
authors.forename: Corinna
authors.initials: C
authors.lastname: Seliger
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.|Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, USA.|Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.
authors.forename: Christoph R
authors.initials: CR
authors.lastname: Meier
authors.affiliation: Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Boston University, Boston, USA.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Jick
authors.affiliation: Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Uhl
authors.affiliation: Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bogdahn
authors.affiliation: Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hau
authors.affiliation: Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
authors.forename: M F
authors.initials: MF
authors.lastname: Leitzmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000188:drug therapy*; D002301:Cardiac Glycosides / Q000494:pharmacology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000453:epidemiology / Q000517:prevention & control*; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D055815:Young Adult
chemical_list: D002301:Cardiac Glycosides
keywords: Case-control studies; Epidemiology; Glioma; Glycosides