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Research article:

Sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the CPRD primary care database

Reference:

Caroline Fairhurst, Fabiola Martin, Ian Watt, Tim Doran, Martin Bland, William J. Brackenbury(2016) Sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the CPRD primary care database. BMJ Open, doi:

Link to fulltext article
Abstract
Introduction: Voltage-gated sodium channel (VGSC)-inhibiting drugs are commonly used to treat epilepsy and cardiac arrhythmia. VGSCs are also widely expressed in various cancers, including those of the breast, bowel and prostate. A number of VGSC-inhibiting drugs have been shown to inhibit cancer cell proliferation, invasion, tumour growth and metastasis in preclinical models, suggesting that VGSCs may be novel molecular targets for cancer treatment. Surprisingly, we previously found that prior exposure to VGSC-inhibiting drugs may be associated with reduced overall survival in cancer patients, but we were unable to control for cause of death or indication for prescription. The purpose of the present study is to interrogate a different database in order to further investigate the relationship between VGSC-inhibiting drugs and cancer-specific survival. Methods and analysis: A cohort study using primary care data from the Clinical Practice Research Datalink (CPRD) database will include patients with diagnosis of breast, bowel and prostate cancer (approx. n=13,000). The primary outcome will be cancer-specific survival from date of cancer diagnosis. Cox proportional hazards regression will be used to compare survival of patients taking VGSC-inhibiting drugs (including antiepileptic drugs and Class I antiarrhythmic agents) with cancer patients not taking these drugs, adjusting for cancer type, age and sex. Drug exposure will be treated as a time-varying covariate to account for potential immortal time bias. Various sensitivity and secondary analyses will be performed. Ethics and dissemination: The project has been reviewed and approved by the University of York Ethical Review Process. Results will be presented at an international conference and published in open access peer-reviewed journals according to the STROBE and RECORD guidelines.
Author for correspondence
William J. Brackenbury
Email for correspondence
william.brackenbury@york.ac.uk

Code list: res47: Body mass index

13 codes in list

Code Coding system Description Entity type List name
22K..00 Read Body Mass Index test res47: Body mass index
22K1.00 Read Body Mass Index normal K/M2 test res47: Body mass index
22K2.00 Read Body Mass Index high K/M2 test res47: Body mass index
22K3.00 Read Body Mass Index low K/M2 test res47: Body mass index
22K4.00 Read Body mass index index 25-29 - overweight test res47: Body mass index
22K5.00 Read Body mass index 30+ - obesity test res47: Body mass index
22K6.00 Read Body mass index less than 20 test res47: Body mass index
22K7.00 Read Body mass index 40+ - severely obese test res47: Body mass index
22K8.00 Read Body mass index 20-24 - normal test res47: Body mass index
22K9.00 Read Body mass index centile test res47: Body mass index
22K9000 Read Baseline body mass index centile test res47: Body mass index
22KA.00 Read Target body mass index test res47: Body mass index
22KB.00 Read Baseline body mass index test res47: Body mass index

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