Following adjustment for race, pretransplant skin cancer history, age, diabetes diagnosis, and immunosuppression, there were no significant chemopreventive effects found for metformin or niacin/nicotinic acid.
Clinical Pearls
This retrospective review analyzed all solid-organ transplant patients and their chemoprevention regimens for skin cancer at a single institution
529 solid-organ transplant recipients were studied with 203 developing 1,571 skin cancers over the study’s course
Following adjustment for race, pretransplant skin cancer history, age, diabetes diagnosis, and immunosuppression, there were no significant chemopreventive effects found for metformin or niacin/nicotinic acid
Discussion:
In this research letter by Linkous et al published in the Journal of the American Academy of Dermatology, the chemopreventive effect of metformin, niacinamide, niacin, and nicotinic acid is investigated. Via retrospective medical record review, the authors studied all solid organ transplant recipients (SOTR) seen by dermatologists from the authors’ institution between January 2012 and June 2022.
529 SOTR were seen by dermatologists during the studied time period, with 203 of these developing a total of 1,571 skin cancers. The majority of patients were prescribed metformin (101, 19%) or niacin/nicotinic acid (127, 24%) while only 3 (0.01%) were prescribed niacinamide. Several patients were prescribed more than 1 of these chemopreventive medications.
Using multivariate logistic regression to adjust for race, pretransplant skin cancer history, age, diabetes diagnosis, and immunosuppression, the authors found no significant effect in prevention of posttransplant skin cancers with metformin or niacin/nicotinic acid. Analysis of niacinamide was limited due to the small sample size. Overall, this study provides valuable data raising question to the chemopreventive effects of metformin, niacin, or nicotinic acid in the development of skin cancer.
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