Evaluating Confounding Control in Estimations of Influenza Antiviral Effectiveness in Electronic Health Plan Data

Angiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort study

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is one of the most prevalent specific chronic respiratory diseases. It could worsen the development of cardiovascular diseases (CVD) and lung cancer. We aimed to elucidate the relationship between the use of angiotensin receptor blockers (ARBs) and the incidence of lung cancer among the COPD population in China.

METHODS

This retrospective cohort included COPD patients identified by the international classification of diseases 10th edition (ICD-10) codes in the Yinzhou Regional Health Care Database. The use of ARBs was defined according to the use and cumulative use. The lung cancer was defined by ICD-10 code (up to 2023). Time-varying Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the use of ARBs on the risk of lung cancer.

RESULTS

This population-based COPD cohort comprised 25,436 patients with an average age of 68.2 years (standard deviation [SD]: 12.59 years), of which 60.6% were male. A total of 8,611 patients received at least one prescription for ARBs. After adjusting for multiple covariates, the results showed that cumulative annual exposure to ARBs was associated with a reduced risk of lung cancer (HR: 0.93, 95% CI: 0.90-0.97). The results of sensitivity analyses and negative control exposure analyses indicated that the associations were largely consistent and less likely to be influenced by unobserved confounding.

CONCLUSIONS

The use of ARBs may reduce the risk of lung cancer among patients with COPD.

Pre- and post-Ad26.COV2·S booster dose antibody levels predict COVID-19 disease risk

Identifying immune correlates of risk following COVID-19 vaccine boosters has become paramount as a result of the challenges in generating additional efficacy data. The trial data described here was collected in the United States, with a large part of the study conduct coinciding with the emergence of the SARS-CoV-2 Omicron BA.1 variant. The vaccine trial involved the administration of a booster dose of Ad26.COV2·S at least 6 months after primary vaccination with either a single dose of Ad26.COV2·S or a 2-dose BNT162b2 vaccine regimen. Immunogenicity was assessed through Wuhan Spike binding antibodies (bAb), neutralizing antibodies (nAb), and Omicron BA.1 cross-neutralizing antibodies (nAb BA.1) at Day 1 (pre-boost), Day 15-, and 6-months post-boost. Immune correlates analyses demonstrate that, higher titers of bAb, nAb, and nAb BA.1 at Day 15 were consistently associated with a lower risk of symptomatic COVID-19 following a booster dose of Ad26.COV2·S, irrespective of the primary vaccine regimen. Similar results were obtained using multivariable analyses. Furthermore, Day 1 nAb levels against the Wuhan reference strain exhibited a statistically significant inverse relationship with the risk of symptomatic COVID-19. These findings highlight the value of assessing immune correlates for vaccine boosters, especially in the context of emerging SARS-CoV-2 variants. Clinical trials registration:NCT04999111.