Monday, December 19, 2016

Ibuprofen could reduce smokers' risk of death from lung cancer

Ibuprofen could reduce smokers' risk of death from lung cancer

Ibuprofen is a medication commonly used to reduce pain and inflammation, but a new study suggests its benefits do not stop there. Researchers have found that the drug may also reduce the risk of death from lung cancer among former and current smokers.


Study co-author Dr. Marisa Bittoni, of The Ohio State University, and colleagues recently presented their findings at the IASLC 17th World Conference on Lung Cancer (WCLC) in Vienna, Austria.


Lung cancer is one of the most common cancers in the United States, accounting for around 14 percent of new cancer cases.


This year, it is estimated that around 224,390 people in the U.S. will be diagnosed with lung cancer, and more than 158,000 Americans will die from the disease, making it the leading cause of cancer death in both men and women.


Smoking is the primary cause of lung cancer, associated with around 80-90 percent of lung cancer cases in the U.S.


According to the Centers for Disease Control and Prevention (CDC), people who smoke are 15-30 times more likely to develop lung cancer or die from the disease than nonsmokers.


Previous studies have shown that chronic inflammation is associated with increased risk of lung cancer. Since ibuprofen is a medication that reduces inflammation, Dr. Bittoni and colleagues set out to investigate whether the drug might benefit people with a history of smoking

Ibuprofen reduced lung cancer death risk by 48 percent



To reach their findings, the team analyzed the data of 10,735 adults who were part of the Third National Health and Nutrition Examination Survey (NHANES III), enrolling between 1988-1994.

Subjects' smoking status, use of ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs), and information on other lifestyle factors were gathered at study baseline.


Participants were followed-up for an average of 18 years, and the researchers pinpointed their cause-specific mortality status using data from the National Death Index up until 2006.


The researchers used Cox proportional hazards regression models to estimate how NSAID use was associated with the risk of lung cancer death.


During follow-up, 269 of the participants died from lung cancer, of whom 252 had a history of smoking.


Because the vast majority of lung cancer cases were among past or current smokers, the team also calculated the effects of NSAIDs in a further sample of 5,882 adults with a history of smoking.


Overall, the team found that former or current smokers who regularly used ibuprofen were 48 percent less likely to die from lung cancer than those who did not use the drug.



The link between lung cancer death risk and the use of aspirin - another common NSAID - was not statistically significant, the authors report.


Quitting smoking and adopting a healthy lifestyle remain the best ways to lower lung cancer risk. However, Dr. Bittoni and colleagues believe their findings suggest regular ibuprofen use might be valuable for some people.

ACE Inhibitors

ACE Inhibitors

For what conditions are ACE inhibitors used?


    ACE inhibitors are used for
        controlling acute and chronic high blood pressure,
        treating left ventricular dysfunction and heart failure,
        preventing strokes, and
        preventing and treating kidney disease (nephropathy) in people with hypertension or diabetes.
    ACE inhibitors also improve survival after heart attacks. In studies, individuals with hypertension, heart failure, or prior heart attacks who were treated with an ACE inhibitor lived longer than patients who did not take an ACE inhibitor.
    ACE inhibitors are an important group of drugs because they prevent early death resulting from hypertension, heart failure or heart attacks.
    Some individuals with hypertension do not respond sufficiently to ACE inhibitors alone. In these cases, other drugs often are used in combination with ACE inhibitors.

Are there any differences among the different types of ACE inhibitors?


ACE inhibitors are very similar. However, they differ in how they are eliminated from the body and their doses. Some ACE inhibitors remain in the body longer than others, and are given once a day. Some ACE inhibitors need to be converted into an active form in the body before they work. In addition, some ACE inhibitors may work more on ACE that is found in tissues than on ACE that is present in the blood. The importance of this difference or whether one ACE inhibitor is better than another has not been determined.

ACE Inhibitors

ACE Inhibitors

What are the side effects of ACE inhibitors?


ACE inhibitors are well-tolerated by most individuals. Nevertheless, they are not free of side effects, and some patients should not use ACE inhibitors.

ACE inhibitors usually are not prescribed for pregnant women because they may cause birth defects.

Individuals with bilateral renal artery stenosis (narrowing of the arteries that supply the kidneys) may experience worsening of kidney function, and people who have had a severe reaction to ACE inhibitors probably should avoid them.

The most common side effects are:

    Cough
    Elevated blood potassium levels
    Low blood pressure,
    dizziness
    Headache
    Drowsiness
    Weakness
    Abnormal taste (metallic or salty taste)
    Rash
    Chest pain
    Increased uric acid levels
    Sun sensitivity
    Increased BUN and creatinine levels

It may take up to a month for coughing to subside, and if one ACE inhibitor causes cough it is likely that the others will too.

The most serious, but rare, side effects of ACE inhibitors are:

    kidney failure,
    allergic reactions,
    pancreatitis
    liver dysfunction
    a decrease in white blood cells, and
    swelling of tissues (angioedema).

ACE Inhibitors

ACE Inhibitors

What are ACE inhibitors, and how do they work?


Angiotensin II is a very potent chemical produced by the body that primarily circulates in the blood. It causes the muscles surrounding blood vessels to contract, thereby narrowing the vessels. The narrowing of the
vessels increases the pressure within the vessels causing increases in blood pressure (hypertension). Angiotensin II is formed from angiotensin I in the blood by the enzyme angiotensin converting enzyme (ACE). (Angiotensin I in the blood is itself formed from angiotensinogen, a protein produced by the liver and released into the blood..) angiotensin converting enzyme inhibitors (ACE inhibitors) are medications that slow (inhibit) the activity of the enzyme ACE, which decreases the production of angiotensin II. As a result, blood vessels enlarge or dilate, and blood pressure is reduced. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.

What are some examples of ACE inhibitors?


The following is a list of the ACE inhibitors that are available in the United States:

    benazepril (Lotensin)
    captopril (Capoten)
    enalapril (Vasotec, Epaned)
    fosinopril (Monopril)
    lisinopril (Prinivil, Zestril)
    moexipril (Univasc)
    perindopril (Aceon)
    quinapril (Accupril)
    ramipril (Altace)
    trandolapril (Mavik)