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Research article:
Exposure to sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the QResearch primary care database
Reference:
Caroline Fairhurst, Ian Watt, Fabiola Martin, Martin Bland, and William J. Brackenbury(2014) Exposure to sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the QResearch primary care database. BMJ Open, doi:
- Link to fulltext article
- Abstract
- Introduction: Metastasis from solid tumours is associated with significant morbidity and mortality, and is the leading cause of cancer-related deaths. Voltage-gated sodium channels (VGSCs) are drug targets for the treatment of epilepsy. VGSCs are also present in cancer cells, where they regulate metastatic cell behaviours, including cellular movement and invasion. Treating cancer cells with the VGSC-inhibiting anticonvulsant phenytoin reduces cellular invasion and migration. Together, these suggest that VGSCs may be useful targets for inhibiting metastasis. The purpose of this study is to test the hypothesis that use of VGSC-inhibiting drugs will reduce metastasis, and therefore increase survival time in cancer patients. Methods and analysis: A cohort study based on primary care data from the QResearch database will include patients with one of three common tumours: breast, bowel, and prostate. The primary outcome will be overall survival from date of cancer diagnosis. Cox proportional hazards regression will be used to compare the survival of cancer patients taking VGSC-inhibiting drugs (including anticonvulsants and Class I antiarrhythmic agents) with cancer patients not exposed to these drugs, adjusting for age and sex. Exposure to VGSC-inhibiting drugs will be defined as having at least one prescription for these drugs prior to cancer diagnosis. High and low exposure groups will be identified based on length of use. A number of sensitivity and secondary analyses will be conducted. Ethics and dissemination: The protocol has been independently peer-reviewed and approved by the QResearch Scientific Board. The project has also been approved by the University of York Ethical Review Process. The results will be presented at international conferences and published in an open access peer-reviewed journal, in accordance with the STROBE criteria.
- Author for correspondence
- William J. Brackenbury
- Email for correspondence
- william.brackenbury@york.ac.uk
Code list: res17: Alcohol status
59 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 136 | Read | Alcohol consumption | test | res17: Alcohol status | |||
| 1361 | Read | Teetotaller | test | res17: Alcohol status | |||
| 1361-1 | Read | Non drinker alcohol | test | res17: Alcohol status | |||
| 1361-2 | Read | Non-drinker alcohol | test | res17: Alcohol status | |||
| 1362 | Read | Trivial drinker - <1u/day | test | res17: Alcohol status | |||
| 1362-1 | Read | Drinks rarely | test | res17: Alcohol status | |||
| 1362-2 | Read | Drinks occasionally | test | res17: Alcohol status | |||
| 1363 | Read | Light drinker - 1-2u/day | test | res17: Alcohol status | |||
| 1364 | Read | Moderate drinker - 3-6u/day | test | res17: Alcohol status | |||
| 1365 | Read | Heavy drinker - 7-9u/day | test | res17: Alcohol status | |||
| 1366 | Read | Very heavy drinker - >9u/day | test | res17: Alcohol status | |||
| 1367 | Read | Stopped drinking alcohol | test | res17: Alcohol status | |||
| 1368 | Read | Alcohol consumption unknown | test | res17: Alcohol status | |||
| 1369 | Read | Suspect alcohol abuse - denied | test | res17: Alcohol status | |||
| 136a | Read | Increasing risk drinking | test | res17: Alcohol status | |||
| 136A | Read | Ex-trivial drinker (<1u/day) | test | res17: Alcohol status | |||
| 136b | Read | Feels should cut down drinking | test | res17: Alcohol status | |||
| 136B | Read | Ex-light drinker - (1-2u/day) | test | res17: Alcohol status | |||
| 136c | Read | Higher risk drinking | test | res17: Alcohol status | |||
| 136C | Read | Ex-moderate drinker - (3-6u/d) | test | res17: Alcohol status | |||
| 136d | Read | Lower risk drinking | test | res17: Alcohol status | |||
| 136D | Read | Ex-heavy drinker - (7-9u/day) | test | res17: Alcohol status | |||
| 136e | Read | Declines to state current alcohol consumption | test | res17: Alcohol status | |||
| 136E | Read | Ex-very heavy drinker-(>9u/d) | test | res17: Alcohol status | |||
| 136F | Read | Spirit drinker | test | res17: Alcohol status | |||
| 136G | Read | Beer drinker | test | res17: Alcohol status | |||
| 136H | Read | Drinks beer and spirits | test | res17: Alcohol status | |||
| 136I | Read | Drinks wine | test | res17: Alcohol status | |||
| 136J | Read | Social drinker | test | res17: Alcohol status | |||
| 136K | Read | Alcohol intake above recommended sensible limits | test | res17: Alcohol status | |||
| 136L | Read | Alcohol intake within recommended sensible limits | test | res17: Alcohol status | |||
| 136M | Read | Current non drinker | test | res17: Alcohol status | |||
| 136N | Read | Light drinker | test | res17: Alcohol status | |||
| 136O | Read | Moderate drinker | test | res17: Alcohol status | |||
| 136P | Read | Heavy drinker | test | res17: Alcohol status | |||
| 136Q | Read | Very heavy drinker | test | res17: Alcohol status | |||
| 136R | Read | Binge drinker | test | res17: Alcohol status | |||
| 136S | Read | Hazardous alcohol use | test | res17: Alcohol status | |||
| 136T | Read | Harmful alcohol use | test | res17: Alcohol status | |||
| 136V | Read | Alcohol units per week | test | res17: Alcohol status | |||
| 136X | Read | Alcohol units consumed on heaviest drinking day | test | res17: Alcohol status | |||
| 136Y | Read | Drinks in morning to get rid of hangover | test | res17: Alcohol status | |||
| 136Z | Read | Alcohol consumption NOS | test | res17: Alcohol status | |||
| E23-2 | Read | Alcohol problem drinking | test | res17: Alcohol status | |||
| EGTON418 | Read | Alcohol intake | test | res17: Alcohol status | |||
| EGTONGR6 | Read | Grade A none drinker or rare | test | res17: Alcohol status | |||
| EGTONGR7 | Read | Grade B 0-20 units/week | test | res17: Alcohol status | |||
| EGTONGR8 | Read | Grade C 21-49 units/week | test | res17: Alcohol status | |||
| EGTONGR9 | Read | Grade D 50 or more units/week | test | res17: Alcohol status | |||
| EMISNQUN23 | Read | Unsuccessful attempts to reduce alcohol consumption | test | res17: Alcohol status | |||
| EMISQAL1 | Read | Alcohol AUDIT score | test | res17: Alcohol status | |||
| EMISQAL2 | Read | Alcohol reduction-maintain abstinence | test | res17: Alcohol status | |||
| EMISQAU1 | Read | AUDIT score <4 no drinking problem | test | res17: Alcohol status | |||
| EMISQAU2 | Read | AUDIT score >5 alcohol dependence syndrome | test | res17: Alcohol status | |||
| EMISQAU3 | Read | AUDIT score >5 alcohol problem drinker | test | res17: Alcohol status | |||
| EMISQNO6 | Read | Not interested in reducing alcohol | test | res17: Alcohol status | |||
| EMISQOT3 | Read | Other alcohol related information | test | res17: Alcohol status | |||
| EMISQRE13 | Read | Ready to start reducing alcohol | test | res17: Alcohol status | |||
| EMISQTH4 | Read | Thinking about reducing alcohol | test | res17: Alcohol status |
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