You may recall a past article where I touted the benefits of the Angiotensin Receptor Blocker known as Telmisartan. It not only does a superb job of controlling blood pressure without the dreaded cough many people get from Angiotensin Converting Enzyme Inhibitors (ACE inhibitors, such as Captopril or Lisinopril), but it also possesses a unique PPAR-gamma effect that can help reverse symptoms of Metabolic Syndrome, increase resting energy expenditure, reduce inflammation and reduce the risk of certain types of cancer. Recently, however, this class of drugs has come under fire for its link to a 25% increased risk of certain types of cancer, especially lung cancer.
It’s been known for quite some time that Telmisartan has a whole range of benefits beyond blood pressure control that make it almost seem like a magic bullet for fat loss and insulin sensitivity. It also has been shown to reduce the risk of certain types of cancer such as urological cancer. This is due to its effect on PPAR-gamma.
We previously reported that PPAR-γ is strongly expressed in urological cancer tissues. The extent and intensity of PPAR-γ expression in urological cancer tissues were greater than in normal urological tissues. PPAR-γ ligands strongly induced early apoptosis in urological cancer cells as determined by flow cytometry and Hoechst staining (11–15). In this study, only telmisartan had a direct toxicity through apoptosis. Thus, telmisartan may mediate potent anti-proliferative effects against urological cancer cells through PPAR-γ. However, in our study, that dose was not clinically achievable. Further studies are needed to extend the use of telmisartan to clinical trials for the treatment for human urological cancer.
Well, as early as 2010, though, it seems that evidence has been accumulating which shows that ARB’s, in particular Telmisartan, increase the risk of cancer by 11% and certain types of lung cancer by as much as 25%. That’s no statistically insignificant number if you ask me. In the latest news on this issue, in the Wall Street Journal, it appears a senior regulator at the Food and Drug Administration is pushing, at the behest of his colleagues, for bigger warnings on prescriptions for ARB’s to include this risk.
A year after the review done in 2010, the FDA did its own review and stated their own analysis found “no increase in risk”. Reassuring, right? Well the renegade at the FDA, by the name of Thomas Marciniak wasn’t happy with this meta-analysis. He claims most of the studies looked at by the FDA were studies done by the drug companies themselves, and were therefore skewed to show a different amount of risk. Another little thing the FDA did was to discount any mentioning of Lung Carcinoma, because according to them, this is not lung cancer. Well, according to almost any other medical doctor, yes it is in fact lung cancer.
This isn’t entirely a matter of picking on the poor ol’ FDA, however. The studies that are being reviewed, and some of the studies that were left out, all add up to an observation of correlation. In other words, there is not a study here showing purposefully testing the ability of the ARB drugs to cause cancer. This is data collected from showing its benefits, and the people who participated in the study happened to develop cancer at a rate 25% higher than in the placebo group. That is enough evidence to me to discourage people from using this drug, but it’s not quite enough evidence to claim beyond a shadow of a doubt that ARB’s cause cancer.
To read more about the latest in this debate, click here to read Dispute Flares Inside FDA Over Safety of Popular Blood-Pressure Drugs .