Case-Control Study Examining the Association between Selective Serotonin Reuptake Inhibitors Use and Hepatocellular Carcinoma.

Shih-Wei Lai,Cheng-Li Lin,Kuan-Fu Liao,Hsien-Feng Lin

doi:10.3389/fphar.2017.00861

Abstract

Objectives: The purpose of the study was to assess the relationship between selective serotonin reuptake inhibitors use and hepatocellular carcinoma in Taiwan.Methods: Using the database of the Taiwan National Health Insurance Program, we conducted a case-control study to identify 4901 subjects aged 20 years and more with newly diagnosed hepatocellular carcinoma in 2000–2013 as the cases. We randomly selected 19604 subjects aged 20 years and more without hepatocellular carcinoma as the controls. Both cases and controls were matched with sex and age. Ever use of selective serotonin reuptake inhibitors was defined as a subject who had at least a prescription for selective serotonin reuptake inhibitors before index date. Never use was defined as a subject who never had a prescription for selective serotonin reuptake inhibitors before index date. The odds ratio (OR) and 95% confidence interval (CI) for hepatocellular carcinoma associated with selective serotonin reuptake inhibitors use was estimated by the multivariable logistic regression model.Results: Among subjects with any one of the comorbid conditions associated with hepatocellular carcinoma, the adjusted OR of hepatocellular carcinoma was 0.89 (95% CI 0.75, 1.06) for subjects with ever use of selective serotonin reuptake inhibitors, comparing with never use.Conclusion: The findings indicate that among subjects with any one of the comorbid conditions associated with hepatocellular carcinoma, no significant association can be detected between selective serotonin reuptake inhibitors use and hepatocellular carcinoma.

Highlights

Selective serotonin reuptake inhibitors are used to treat major depressive disorder and anxiety disorder (Hirschfeld, 2000; Baldwin et al, 2002; Hedges et al, 2007)
The cases with hepatocellular carcinoma were more likely to have a higher proportion of ever use of selective serotonin reuptake inhibitors than the controls (7.57% vs. 6.05%, P = 0.001)
Our study focuses on patients with any one of the comorbid conditions associated with hepatocellular carcinoma

Summary

Introduction

Selective serotonin reuptake inhibitors are used to treat major depressive disorder and anxiety disorder (Hirschfeld, 2000; Baldwin et al, 2002; Hedges et al, 2007). An in vitro study showed that selective serotonin reuptake inhibitors seemed to have anti-tumor effects on human hepatocellular carcinoma (Kuwahara et al, 2015). A cohort study showed that selective serotonin reuptake inhibitors use was not significantly associated with increased incidence of hepatocellular carcinoma (Haukka et al, 2010). A case-control study showed that selective serotonin reuptake inhibitors use was significantly associated with decreased odds for hepatocellular carcinoma (Chen et al, 2017). Inconsistent results exit on the relationship between selective serotonin reuptake inhibitors use and hepatocellular carcinoma

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Conclusion