Association between phosphodiesterase type 5 inhibitors use and tisk of melanoma: a meta-analysis

Tuo Deng, Xiaolu Duan, Bing Liu, Yu Lan, Chao Cai, Tao Zhang, Wei Zhu, Zanlin Mai, Wenqi Wu,  Guohua Zeng

Abstract:

This meta-analysis aimed to clarify the actual association between the phosphodiesterase type 5 inhibitors (PDE5-Is) use and the risk of melanoma in erectile dysfunction (ED) patients. A systematic literature search was conducted on online databases in October, 2016 to identify studies focusing on the association between PDE5-Is use and the risk of melanoma. Summarized multivariate adjusted risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to assess the strength of associations. A total of six clinical trials containing more than one million participants were included. ED patients using PDE5-Is shared a significant high risk of melanoma (RR = 1.12, 95% CI = 1.03-1.21, P = 0.006). Positive associations were observed in all kinds of prescriptions: single prescription (RR = 1.20, 95% CI = 1.06 - 1.35, P = 0.003), medium number of prescription (RR = 1.15, 95% CI = 1.01 - 1.30, P = 0.03), and high number of prescription (RR = 1.18, 95% CI = 1.05 - 1.34, P = 0.006). Additionally, PDE5-Is were also found to be significantly associated with increased risk of basal cell carcinoma (RR = 1.14, 95% CI = 1.09 - 1.19, P < 0.00001). Our study indicated that PDE5-Is use could significantly increase the risk of melanoma and basal cell carcinoma. However, the risk of melanoma did not rise significantly with the increased number of prescriptions. Consequently, owing to lacking information about other potential synergistic factors, it is difficult for us to make a solid conclusion that application of PDE5-Is is the direct cause of increased risk of melanoma. Their relationship needs to be validated by further evidences.