Antidepressant use after diagnosis reduces liver cancer mortality

Key points:

• Antidepressant use after liver cancer diagnosis reduces the risk of overall and cancer-specific mortality.
• No association was found between prediagnostic antidepressant use and mortality.

Using antidepressants after diagnosis reduces the risk of death in patients with hepatocellular carcinoma, according to data published in the journal Hepatocellular Carcinoma JAMA Network Open.

The researchers noted that the inverse association between postdiagnosis antidepressant use and reduced mortality risk was consistent across antidepressant drug classes.

“Notably, we observed a consistent inverse association between postdiagnosis antidepressant use and risk of death across a variety of comorbid subgroups, including (hepatitis B virus) infection, (hepatitis C virus) Infections, Cirrhosis, and Alcohol Use Disorders,” Huang Guanlun, Doctor of Medicine,

write professors and colleagues at the Caotun Psychiatric Center in Nantou, Taiwan. “In contrast, no association was observed between antidepressant use before liver cancer diagnosis and reduced cancer-specific or all-cause mortality.”

Background and methods

Liver cancer is now the third leading cause of cancer death worldwide, according to background data provided by the researchers.

Huang and colleagues sought to investigate potential associations between antidepressant use and risk of death in patients with hepatocellular carcinoma in what they believe is the first nationwide cohort study of its kind.

This population-based cohort study analyzed information from the Taiwan National Health Insurance Research Database. The analysis included 308,938 adults (65.6% men; 42.7% 65 years or older) newly diagnosed with hepatocellular carcinoma between 1999 and 2017, with follow-up continuing through 2018 to measure overall and cancer-specific mortality mortality rate.

Analysis of the compiled data was conducted in June 2023.

Results, next steps

Researchers found that use of antidepressants before hepatocellular carcinoma diagnosis was associated with overall mortality (adjusted HR = 1.1; 95% CI, 1.08-1.12) or cancer-specific mortality (adjusted HR = 1.06; 95% CI, 0.96 -1.17) are not related.

However, the researchers did note that antidepressant use after hepatocellular carcinoma diagnosis was associated with a reduced risk of overall mortality (adjusted HR = 0.69; 95% CI, 0.68-0.7) and cancer-specific mortality (adjusted HR = 0.63 ; 95% CI). ,0.59-0.68).

The researchers noted that the observed associations remained consistent across subgroups across antidepressant medication classes and comorbidities, including hepatitis B virus or hepatitis C virus infection, cirrhosis, and alcohol use disorder.

The researchers noted several study limitations, including being limited to Taiwanese population data, not providing information on some potential confounders in the National Health Insurance Research Database, and possible misclassification bias because some study participants were not adherent to their antidepressant medications.

The researchers said further studies through randomized clinical trials are needed to provide clear evidence of a reduced risk of death.

“Our study provides promising empirical results suggesting that antidepressants may serve as anticancer therapies in patients with hepatocellular carcinoma,” Huang and colleagues wrote. “However, our findings should be interpreted with caution because of this observation Associations found in sex studies may not indicate causation and may be subject to residual confounding or bias.”