Erectile dysfunction drug linked to melanoma risk

A small increased risk of malignant melanoma has been found in men in Sweden taking PDE5 inhibitors to treat ED

A small increased risk of malignant melanoma has been found in men in Sweden who were taking phosphodiesterase type 5 (PDE5) inhibitors to treat erectile dysfunction (ED). It is not clear, however, whether the association is causal or due to lifestyle factors.
Researchers at New York University and colleagues based in Sweden and London investigated the link between the use of PDE5 inhibitors and the risk of malignant melanoma.
They examined data from the Swedish Prescribed Drug Register, the Swedish Melanoma Register and other Swedish healthcare registers and demographic databases and identified cases of melanoma diagnosed between 2006 and 2012.
Of 4,065 men who had melanoma, 435 (11%) had received prescriptions for PDE5 inhibitors (sildenafil, vardenafil or tadalafil), as had 1,713 men out of 20,325 controls (8%).
The analysis showed a modest but statistically significant increased risk of melanoma in the men who were taking PDE5 inhibitors.
The biggest increase in risk was observed in men who had had a single prescription, but was not significant among those who had received multiple prescriptions.
PDE5 inhibitors were significantly associated with low-stage, but not high-stage, melanoma. The men taking PDE5 inhibitors had a higher educational level and annual income, factors that are also significantly associated with the risk of melanoma.
The researchers noted that the association between use of PDE5 inhibitors and melanoma ‘may reflect confounding factors by lifestyle factors associated with PDE5 inhibitor use and low-stage melanoma’.
Loeb S, Folkvaljon Y, Lambe M et al. JAMA 2015; 313(24): 2449-55

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