Background

Current evidence about the association between voriconazole and risk of cutaneous squamous cell carcinoma (SCC) remains inconsistent.

Objective

To assess the association between voriconazole use and risk of SCC.

Methods

We systematically searched PubMed and Embase and performed a random effects model meta-analysis to calculate the pooled relative risk (RR) with a 95% confidence interval (CI).

Results

Of the 8 studies involving a total of 3710 individuals with a lung transplant or hematopoietic cell transplant that were included in the qualitative analysis, 5 were included in the meta-analysis. Use of voriconazole was significantly associated with increased risk of SCC (RR, 1.86; 95% CI, 1.36-2.55). The increased risk did not differ according to type of transplantation or adjustment for sun exposure. Longer duration of voriconazole use was found to be positively associated with risk of SCC (RR, 1.72; 95% CI, 1.09-2.72). Voriconazole use was not associated with increased risk of basal cell carcinoma (RR, 0.84; 95% CI, 0.41-1.71).

Limitations

There were some heterogeneities in the retrospective observational studies.

Conclusions

Our findings support an increased risk of SCC associated with voriconazole in individuals with a lung transplant or hematopoietic cell transplant. Routine dermatologic surveillance should be performed, especially among individuals at high risk of developing SCC.

中文翻译：

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伏立康唑暴露与肺或造血细胞移植患者皮肤鳞状细胞癌的风险：系统评价和荟萃分析

背景

关于伏立康唑与皮肤鳞状细胞癌（SCC）风险之间的关联的当前证据仍然不一致。

客观的

评估伏立康唑使用与SCC风险之间的关联。

方法

我们系统地搜索了PubMed和Embase，并进行了随机效应模型荟萃分析，以95％的置信区间（CI）计算合并的相对风险（RR）。

结果

在涉及定性分析的涉及肺移植或造血细胞移植的总共3710名患者的8项研究中，有5项纳入荟萃分析。伏立康唑的使用与SCC风险增加显着相关（RR，1.86； 95％CI，1.36-2.55）。根据移植类型或对日照的调整，增加的风险没有差异。伏立康唑的长期使用与SCC风险呈正相关（RR，1.72； 95％CI，1.09-2.72）。伏立康唑的使用与基底细胞癌的风险增加无关（RR，0.84； 95％CI，0.41-1.71）。

局限性

回顾性观察研究存在一些异质性。

结论

我们的发现支持在进行肺移植或造血细胞移植的患者中，与伏立康唑相关的SCC风险增加。应当进行常规的皮肤病学监测，尤其是在发生SCC的高风险人群中。