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Tamoxifen usage correlates with increased risk of Parkinson’s disease in older women with breast cancer: a case–control study in Taiwan

  • Pharmacoepidemiology and Prescription
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Abstract

Background and objectives

Little is known about the association between tamoxifen usage and risk of Parkinson’s disease in women with breast cancer. The present study aimed to evaluate the association between tamoxifen usage and Parkinson’s disease in older women with breast cancer in Taiwan.

Methods

We conducted a retrospective nationwide case–control study using the database of the Taiwan National Health Insurance Program. In total, 293 female subjects with breast cancer, aged 65 years and above, who were newly diagnosed with Parkinson’s disease between 2000 and 2011 were included. Additionally, 1053 female subjects with breast cancer aged 65 years and above without Parkinson’s disease were randomly selected as controls. Both cases and controls were matched for age and comorbidities. Ever use of tamoxifen was defined as subjects who had at least a prescription for tamoxifen before the index date, whereas never use of tamoxifen was defined as those who never had a prescription for tamoxifen before the index date. We used the unconditional logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) for the association between tamoxifen usage and risk of Parkinson’s disease.

Results

After adjusting for confounding variables, the adjusted OR of Parkinson’s disease was 3.32 for subjects with ever use of tamoxifen (95% CI, 2.50–4.43), compared with nonusers. Further analysis showed that the adjusted ORs of Parkinson’s disease were 3.21 (95% CI, 2.29–4.49), 3.95 (95% CI, 2.77–5.64), and 11.4 (95% CI, 2.63–49.7) for subjects with < 2, 2–6, and ≥ 6 years of cumulative tamoxifen usage, respectively, when compared with nonusers.

Conclusions

Tamoxifen usage was associated with a 3.32-fold increase in the likelihood of having Parkinson’s disease among older women with breast cancer in Taiwan.

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Funding

This study was supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW106-TDU-B-212-113004); China Medical University Hospital; Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10601010036); Taiwan Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan; and Katsuzo and Kiyo AoshimaMemorial Funds, Japan. These funding agencies did not influence the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Hsien-Feng Lin, Kuan-Fu Liao and Ching-Mei Chang contributed equally to this study.

Authors and Affiliations

  1. School of Chinese Medicine, China Medical University, Taichung, Taiwan

    Hsien-Feng Lin

  2. Department of Family Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung City, 404, Taiwan

    Hsien-Feng Lin & Shih-Wei Lai

  3. Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan

    Kuan-Fu Liao

  4. College of Medicine, Tzu Chi University, Hualien, Taiwan

    Kuan-Fu Liao

  5. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan

    Kuan-Fu Liao

  6. Department of Nursing, Tungs’ Taichung Metro Habor Hospital, Taichung, Taiwan

    Ching-Mei Chang

  7. College of Medicine, China Medical University, Taichung, Taiwan

    Cheng-Li Lin & Shih-Wei Lai

  8. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Cheng-Li Lin

Authors
  1. Hsien-Feng Lin
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  2. Kuan-Fu Liao
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  5. Shih-Wei Lai
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Contributions

Hsien-Feng Lin and Kuan-Fu Liao planned and conducted this study, participated in the data interpretation, and revised the article.

Ching-Mei Chang and Cheng-Li Lin conducted the data analysis and revised the article.

Shih-Wei Lai planned and conducted this study, contributed to the conception of the article, initiated the draft of the article, and revised the article.

Corresponding author

Correspondence to Shih-Wei Lai.

Ethics declarations

The study was approved by the Research Ethics Committee of China Medical University and Hospital in Taiwan (CMUH-104-REC2-115).

Conflict of interest

The authors declare that they have no conflicts of interest.

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Lin, HF., Liao, KF., Chang, CM. et al. Tamoxifen usage correlates with increased risk of Parkinson’s disease in older women with breast cancer: a case–control study in Taiwan. Eur J Clin Pharmacol 74, 99–107 (2018). https://doi.org/10.1007/s00228-017-2341-0

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  • DOI: https://doi.org/10.1007/s00228-017-2341-0

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