A population-based study found that smokers using enzyme-inducing antiseizure drugs (ASDs) have lower risk estimates of chronic obstructive pulmonary disease (COPD) and lung cancer. The findings were published in the British Journal of Clinical Pharmacology.
The case-control study included 5952 incident cases of COPD and 1373 incident cases of lung cancer matched with 59,328 and 13,681 control participants, respectively, selected from a population of smokers receiving one or more ASDs in the UK Clinical Practice Research Datalink database.
The findings showed that the use of enzyme-inducing ASDs in smokers was associated with slightly lower risk estimates of COPD (aOR, 0.85; 95% CI, 0.81-0.89) and lung cancer (aOR, 0.82; 95% CI, 0.73-0.92) compared with the use of non-enzyme-inducing ASDs.
The association remained significant for light or moderate smokers and short-term users of enzyme-inducing ASDs, but not for medium- and long-term users of enzyme-inducing ASDs who were moderate or heavy smokers.
According to the authors, the exact molecular pathways underlying the association are not fully understood, but one possible theory could be that enzyme-inducing ASDs result in an increase in the activity of detoxifying enzymes such as CYP 1A1, CYP 1A2 and glucuronidases. They call for further research to determine the precise role of enzyme induction in the development of COPD and lung cancer.
Leuppi-Taegtmeyer AB, Reinau D, Yilmaz S, Rüegg S, Krähenbühl S, Jick SS, Leuppi JD, Meier CR. Antiseizure drugs and risk of developing smoking-related chronic obstructive pulmonary disease or lung cancer: a population-based case-control study. Br J Clin Pharmacol. 2020 Aug 01 [Epub ahead of print]. doi: 10.1111/bcp.14501. PMID: 32738070. Abstract.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
