Dopamine agonists and risk of lung cancer in patients with restless legs syndrome

Pharmacoepidemiol Drug Saf. 2023 Jul;32(7):726-734. doi: 10.1002/pds.5596. Epub 2023 Feb 21.

Abstract

Purpose: To examine the association between long-term use of dopamine agonists (DAs) and the risk of lung cancer in patients with restless legs syndrome (RLS).

Methods: We conducted a retrospective cohort study using Optum Clinformatics® database. We included adults ≥40 years diagnosed with RLS during the study period (1/2006-12/2016). Follow-up started with the first RLS diagnosis and ended on the earliest of: incident diagnosis of lung cancer, end of enrollment in the database or end of the study period. The exposure of interest was cumulative duration of DAs use, measured in a time-varying manner. We constructed a multivariable Cox regression model to estimate HRs and 95% CIs for the association between lung cancer and cumulative durations of DA use, adjusting for potential confounding variables.

Results: We identified 295 042 patients with a diagnosis of RLS. The mean age of the cohort was 62.9; 66.6% were women and 82.3% were white. The prevalence of any DA exposure was 40.3%. Compared to the reference group (no use and ≤1 year), the crude HRs for lung cancer were 1.16 (95% CI 0.99-1.36) and 1.14 (95% CI 0.86-1.51) for 1-3 years and >3 years of cumulative DA use, respectively. The adjusted HR for lung cancer was 1.05 (95% CI 0.88-1.25) for 1-3 years and 1.02 (95% CI 0.76-1.37) for >3 years of cumulative DA use, respectively.

Conclusions: At typical doses for the clinical management of RLS, long-term DA use was not associated with risk of lung cancer.

Keywords: RLS; dopamine agonists; epidemiology; lung cancer; time-varying exposure.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Dopamine Agonists / adverse effects
  • Female
  • Humans
  • Lung Neoplasms* / chemically induced
  • Lung Neoplasms* / epidemiology
  • Male
  • Proportional Hazards Models
  • Restless Legs Syndrome* / chemically induced
  • Restless Legs Syndrome* / epidemiology
  • Retrospective Studies

Substances

  • Dopamine Agonists