دورية أكاديمية
أعرض في EDS

Comparative effectiveness of treatment of actinic keratosis with topical fluorouracil and imiquimod in the prevention of keratinocyte carcinoma: A cohort study.

التفاصيل البيبلوغرافية
العنوان: Comparative effectiveness of treatment of actinic keratosis with topical fluorouracil and imiquimod in the prevention of keratinocyte carcinoma: A cohort study.
المؤلفون: Neugebauer R; Division of Research, Kaiser Permanente Northern California, Oakland, California., Su KA; Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts., Zhu Z; Division of Research, Kaiser Permanente Northern California, Oakland, California., Sokil M; Division of Research, Kaiser Permanente Northern California, Oakland, California., Chren MM; Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee., Friedman GD; Division of Research, Kaiser Permanente Northern California, Oakland, California., Asgari MM; Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts.
المصدر: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2019 Apr; Vol. 80 (4), pp. 998-1005. Date of Electronic Publication: 2018 Nov 17.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 7907132 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6787 (Electronic) Linking ISSN: 01909622 NLM ISO Abbreviation: J Am Acad Dermatol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: St. Louis, Mo., Mosby
مواضيع طبية MeSH: Carcinoma, Basal Cell/*epidemiology , Carcinoma, Squamous Cell/*epidemiology , Fluorouracil/*therapeutic use , Imiquimod/*therapeutic use , Keratosis, Actinic/*drug therapy , Skin Neoplasms/*epidemiology, Administration, Cutaneous ; Aged ; California/epidemiology ; Carcinoma, Basal Cell/prevention & control ; Carcinoma, Squamous Cell/prevention & control ; Comparative Effectiveness Research ; Female ; Fluorouracil/administration & dosage ; Humans ; Imiquimod/administration & dosage ; Intention to Treat Analysis ; Keratinocytes/pathology ; Longitudinal Studies ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Skin Neoplasms/prevention & control
مستخلص: Background: The effectiveness of 5-fluorouracil compared with that of imiquimod for preventing keratinocyte carcinoma is unknown.
Objective: To compare the effectiveness of 5-fluorouracil and that of imiquimod in preventing keratinocyte carcinoma in a real-world practice setting.
Methods: We identified 5700 subjects who filled prescriptions for 5-fluorouracil or imiquimod for treatment of actinic keratosis in 2007. An intention-to-treat analysis controlling for potential confounding variables was used to calculate 2- and 5-year cumulative risk differences for subsequent keratinocyte carcinoma overall and in field-treated areas.
Results: 5-Fluorouracil was associated with a statistically significant decreased risk of any keratinocyte carcinoma compared with imiquimod (adjusted hazard ratio [aHR], 0.86; 95% confidence interval [CI], 0.76-0.97), but there were no significant differences in risk by tumor subtype (for squamous cell carcinoma: aHR, 0.89; 95% CI, 0.74-1.07; for basal cell carcinoma: aHR, 0.87; 95% CI, 0.74-1.03) or site-specific keratinocyte carcinoma (aHR, 0.96; 95% CI, 0.81-1.14). There were no significant differences in 2- or 5-year cumulative risk of keratinocyte carcinoma among those treated with 5-fluorouracil versus with imiquimod.
Limitations: Generalizability to other practice settings may be limited.
Conclusions: Whereas 5-fluorouracil was more effective in reducing keratinocyte carcinoma risk overall, we found no differences in the short- or long-term risk of subsequent site-specific keratinocyte carcinoma in a real-world practice setting.
(Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: K24 AR069760 United States AR NIAMS NIH HHS; R03 AR064014 United States AR NIAMS NIH HHS
فهرسة مساهمة: Keywords: 5-fluorouracil; actinic keratosis; basal cell carcinoma; comparative effectiveness; imiquimod; keratinocyte carcinoma; skin cancer; squamous cell carcinoma
المشرفين على المادة: P1QW714R7M (Imiquimod)
U3P01618RT (Fluorouracil)
تواريخ الأحداث: Date Created: 20181121 Date Completed: 20190412 Latest Revision: 20200401
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC6420864
DOI: 10.1016/j.jaad.2018.11.024
PMID: 30458208
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-6787
DOI:10.1016/j.jaad.2018.11.024