title: Digoxin use after diagnosis of prostate cancer and survival: a population-based cohort study.
abstract: Preclinical studies have shown that digoxin exerts anticancer effects on different cancer cell lines including prostate cancer. A recent observational study has shown that digoxin use was associated with a 25% reduction in prostate cancer risk. The aim of this study was to investigate whether digoxin use after diagnosis of prostate cancer was associated with decreased prostate cancer-specific mortality.
  
  
  
  A cohort of 13 134 patients with prostate cancer newly diagnosed from 1998 to 2009 was identified from English cancer registries and linked to the UK Clinical Practice Research Datalink (to provide digoxin and other prescription records) and to the Office of National Statistics mortality data (to identify 2010 prostate cancer-specific deaths). Using time-dependent Cox regression models, unadjusted and adjusted hazard ratios (HR) and 95% confidence intervals (CIs) were calculated for the association between post-diagnostic exposure to digoxin and prostate cancer-specific mortality.
  
  
  
  Overall, 701 (5%) patients with prostate cancer used digoxin after diagnosis. Digoxin use was associated with an increase in prostate cancer-specific mortality before adjustment (HR = 1.59; 95% CI 1.32-1.91), but after adjustment for confounders, the association was attenuated (adjusted HR = 1.13; 95% CI 0.93-1.37) and there was no evidence of a dose response.
  
  
  
  In this large population-based prostate cancer cohort, there was no evidence of a reduction in prostate cancer-specific mortality with digoxin use after diagnosis. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK.
authors.forename: Reema A
authors.initials: RA
authors.lastname: Karasneh
authors.affiliation: Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK.|Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland, UK.
authors.forename: Liam J
authors.initials: LJ
authors.lastname: Murray
authors.affiliation: School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK.
authors.forename: Carmel M
authors.initials: CM
authors.lastname: Hughes
authors.affiliation: Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK.
authors.forename: Chris R
authors.initials: CR
authors.lastname: Cardwell
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D004077:Digoxin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D012042:Registries; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D004077:Digoxin
keywords: cardiac glycosides; digoxin; epidemiology; mortality; pharmacoepidemiology; prostate cancer