Three Cases of Pemphigus Vegetans: Induction by Enalapril—association With Internal Malignancy

Bastiaens, Maarten T.; ZWAN, NEL VERBURGH-VD; Verschueren, G. L. A.; Stoof, T.J.; Nieboer, C.

doi:10.1111/j.1365-4362.1994.tb04942.x

Cited by 49 publications

(14 citation statements)

References 18 publications

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“…Several case reports described an association between the use of ACE inhibitors and malignancy [91][92][93][94][95]. In two case reports, captopril was associated with Kaposi's sarcoma [93,95], in one case report enalapril was associated with lung cancer [91], and in two case reports captopril and enalapril were associated with mycosis fungoides-like lesions [93,95]. In two randomized controlled trials, ACE inhibitors appeared to be associated with increased mortality from cancer [96,97].…”

Section: Angiotensin Converting Enzyme Inhibitorsmentioning

confidence: 98%

“…Despite the ability of angiotensin converting enzyme (ACE) inhibitors to inhibit proliferation of neoplastic cells, there is indirect evidence that use of ACE inhibitors may be associated with increased cancer incidence or mortality. Several case reports described an association between the use of ACE inhibitors and malignancy [91][92][93][94][95]. In two case reports, captopril was associated with Kaposi's sarcoma [93,95], in one case report enalapril was associated with lung cancer [91], and in two case reports captopril and enalapril were associated with mycosis fungoides-like lesions [93,95].…”

Section: Angiotensin Converting Enzyme Inhibitorsmentioning

confidence: 99%

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Carcinogenicity of antihypertensive therapy

Grossman¹,

Messerli

Goldbourt³

2002

Current Science Inc

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Several studies have suggested that antihypertensive treatment may promote cancer through unknown mechanisms. Early retrospective studies implicated reserpine in breast cancer, but data from prospective studies and meta-analysis of several case-controlled studies showed only a weak association between reserpine and breast cancer which, although statistically significant, is of little clinical concern. Data from case-controlled studies and several cohort studies suggested an association between the use of a diuretic and the occurrence of renal cell cancer, particularly in women. A recent study showed an association between the use of a diuretic and the occurrence of colon cancer. Several prospective studies showed that treatment with atenolol may increase mortality from malignancy. However, other studies that analyzed data from several thousand patients could not confirm this association. In three prospective and a few case-controlled studies, angiotensin converting enzyme inhibitors were not associated with increased mortality from malignancy. In addition, a recent retrospective study showed that long-term use of angiotensin converting enzyme inhibitors had a protective effect against malignancy. Data from three large case-controlled studies and the combined data from eight randomized controlled studies and seven longitudinal studies showed a similar risk for malignancy among users and nonusers of calcium antagonists. Until further data from prospective clinical trials are available, we advise caution about long-term diuretic therapy in women. With regard to other antihypertensive drug classes, we suggest continuing the management of hypertension according to current treatment guidelines with little fear of any substantial cancer risk.

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Section: Angiotensin Converting Enzyme Inhibitorsmentioning

confidence: 98%

Section: Angiotensin Converting Enzyme Inhibitorsmentioning

confidence: 99%

Carcinogenicity of antihypertensive therapy

Grossman¹,

Messerli

Goldbourt³

2002

Current Science Inc

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“…Despite the ability of ACE inhibitors to obstruct proliferation of neoplastic cells, there is indirect evidence that use of ACE inhibitors may be associated with increased cancer incidence or mortality. Several case reports described an association between the use of ACE inhibitors and malignancy [47][48][49][50]. In two case reports, captopril was associated with Kaposi's sarcoma [48,49].…”

Section: Angiotensin-converting Enzyme Inhibitorsmentioning

confidence: 99%

Carcinogenicity of cardiovascular drugs

Grossman

Messerli

Goldbourt

1999

Current Science Inc

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Antihypertensive treatment may promote cancer through unknown mechanisms. Early retrospective studies implicated reserpine in breast cancer, but the drug was later absolved by prospective analyses. Data from case-controlled studies and several cohort studies suggested an association between the use of a diuretic and the occurrence of renal cell cancer. Several prospective studies showed that treatment with atenolol may increase mortality from malignancy. However, other studies that analyzed data from several thousand patients could not confirm this association. In two prospective studies, angiotensin-converting enzyme (ACE) inhibitors were associated with increased mortality from malignancy, but a few case-controlled studies showed no association between use of ACE inhibitors and malignancy. In addition, a recent retrospective study showed that long-term use of ACE inhibitors had a protective effect against malignancy. In some studies, calcium antagonists were implicated in increasing the risk for cancer; however, two large case-controlled studies and the combined data from nine observational studies showed a similar risk for malignancy among users and nonusers of a calcium antagonist. Ongoing long-term prospective studies will tell us more about the carcinogenicity of cardiovascular drugs.

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“…As mentioned before, these widely prescribed antihypertensive agents (table 3) are capable of inducing pemphigus independently from the thiol group that features their progenitor captopril [17, 18, 19, 20, 21]. In particular, enalapril, a nonthiol drug, which in vitro shows an acantholytic potential tenfold greater than captopril [22], can in vivo induce true pemphigus [19]or even a subclinical form of the disease [23].…”

Section: Drug Intakementioning

confidence: 99%

“…In particular, enalapril, a nonthiol drug, which in vitro shows an acantholytic potential tenfold greater than captopril [22], can in vivo induce true pemphigus [19]or even a subclinical form of the disease [23]. …”

Section: Drug Intakementioning

confidence: 99%

Precautions and Suggestions for Pemphigus Patients

2001

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The onset and course of pemphigus are often the result of an interaction between predisposing genetic factors and environmental triggering agents. The latter are heterogeneous, numerous and increasing, ranging from drug intake (the commonest cause of pemphigus induction) to the exposure to physical agents (heat, UV and ionizing rays, surgical and cosmetic procedures), viral infections (especially by herpesvirus), contact dermatitis, certain diet ingredients and even emotional stress. Alerting physicians and pemphigus patients to the effects that unsuspected precipitating factors may have on the progression of the disease is an important task. In fact, avoiding or limiting deleterious habits (e.g. overindulging in unnecessary drugs) and suggesting alternative ways (e.g. substituting potentially pemphigus-inducing drugs with others considered harmless in this respect) may be a useful precaution in the management of pemphigus patients, since it can improve the efficacy of conventional treatments, reduce the risks of relapses and sometimes result in a cure.

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Three Cases of Pemphigus Vegetans: Induction by Enalapril—association With Internal Malignancy

Cited by 49 publications

References 18 publications

Carcinogenicity of antihypertensive therapy

Carcinogenicity of antihypertensive therapy

Carcinogenicity of cardiovascular drugs

Precautions and Suggestions for Pemphigus Patients

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