Impact of NBBs on EOC: Emulated Trial

August, 08, 2024 | Gynecologic Cancer, Ovarian Cancer

KEY TAKEAWAYS

  • The study aimed to evaluate the link between continued NBBs use and reduced EOC risk.
  • Researchers noticed that continued NBBs use reduces the risk of EOC.

Epithelial ovarian cancer (EOC) ranks as the 8 most prevalent cancer among women, with generally poor survival rates. Previous observational studies have suggested that nitrogen-based bisphosphonates (NBBs) might be linked to a reduced risk of EOC, especially for endometrioid and serous subtypes. However, confounding factors related to the indication for NBB use present challenges in interpreting these findings.

Karen M Tuesley and the team aimed to emulate a target trial by identifying women who initiated NBB therapy and compared the risk of EOC between those who continued and those who discontinued NBB use.

They performed an inclusive analysis using population-based linked data to identify Australian women over 50 years old who first used NBBs between 2004 and 2012. The year following the first use was utilized to classify each woman’s treatment as either continued or discontinued.

Stabilized inverse probability weights were employed to emulate randomization and balance the treatment groups based on age, comorbidities, and socioeconomic status covariates. Patients were followed from the time of treatment assignment until the diagnosis of EOC, death, or 31 December 2013. The risk of EOC, including histotype, was assessed using flexible parametric time-to-event models with time-varying effects and coefficients.

About 313,383 women were included in the study, with 472 diagnosed with (261 serous EOC) during follow-up, and an average age at diagnosis of 72 years. Continued use of NBBs was associated with a reduced risk of EOC overall (HR = 0.87, 95% CI: 0.69, 1.10) and serous EOC (HR = 0.71, 95% CI: 0.53, 0.96) compared with discontinued treatment, with these estimates remaining consistent over the 9-year follow-up period.

The study concluded that among women who initiated NBBs treatment, those who continued use experienced 13% and 29% lower hazards of being diagnosed with EOC overall and serous EOC, respectively, compared with those who discontinued use.

This study was funded by the Australian National Health and Medical Research Council.

Source: https://pubmed.ncbi.nlm.nih.gov/39133937/

Tuesley KM, Spilsbury K, Webb PM, et al. (2024). “Use of an emulated trial to investigate the association between use of nitrogen-based bisphosphonates and risk of epithelial ovarian cancer.” Int J Epidemiol. 2024 Jun 12;53(4):dyae108. doi: 10.1093/ije/dyae108. PMID: 39133937.

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