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Use of phosphodiesterase type 5 inhibitors and risk of melanoma: a meta-analysis of observational studies

Authors Han X, Han Y, Zheng Y, Sun Q, Ma T, Dai L, Zhang J, Xu L

Received 26 May 2017

Accepted for publication 20 October 2017

Published 5 February 2018 Volume 2018:11 Pages 711—720


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Samir Farghaly

Xinming Han,1 Yan Han,2 Yongsheng Zheng,1 Qiang Sun,1 Tao Ma,1 Li Dai,1 Junyi Zhang,1 Lianji Xu1

1Plastic Surgery Department, Beijing Tongren Hospital, Capital Medical University, Beijing, 2Plastic and Reconstructive Surgery Department, Chinese PLA General Hospital, Beijing, China

Background: Phosphodiesterase type 5 inhibitor (PE5i) administration may stimulate the proliferation and survival of melanocytes. However, discrepancies remain regarding the association between PDE5i use and melanoma risk in observational studies in humans.
Aim: To evaluate the association between PDE5i use and melanoma in a meta-analysis.
Materials and methods: Studies were identified by searching the PubMed and Embase databases. A random-effects model was applied to synthesize the data. A stratified study was performed to evaluate the influence of study characteristics on outcomes.
Results: Four prospective cohort studies and three case–control studies with 1,534,615 male participants and 16,053 melanoma cases were incorporated. Patients who received a PDE5i had a significantly increased risk for melanoma (adjusted risk ratio [RR] =1.12, 95% CI =1.03–1.33, P=0.008) with moderate heterogeneity (I2=54%). Cohort studies (adjusted RR =1.22, 95% CI =1.02–1.46, P=0.03) largely contributed to this result rather than case–control studies. Subsequent stratified analyses revealed that sildenafil was associated with an increased risk of melanoma (adjusted RR =1.26, 95% CI =1.07–1.50, P=0.007), but tadalafil and vardenafil were not. Also, PDE5i use was associated with a significantly increased risk of in situ melanoma (adjusted RR =1.31, 95% CI =1.01–1.69, P=0.04), but not of localized or nonlocalized melanoma.
Conclusion: PDE5i use may be associated with a significantly increased risk for melanoma in men. However, further research is needed to determine whether the association is causative.

Keywords: phosphodiesterase type 5 inhibitors, melanoma, meta-analysis, sildenafil

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