Twenty seven RCTs (56 treatment arms, n=126,137) were included in the primary analysis and 28 RCTs (n=136,821) in the MTC meta-analysis, individual pair-wise meta analysis and sensitivity analysis. Seven RCTs scored 5 points on the Jadad scale, five scored 4 points, and 15 scored 3 points or less.
Primary analysis (27 RCTs, n=126,137) reported that the overall incidence of cancer averaged 4.7 per cent (number with cancer n=5,868 and total at risk n=126,137) for trials lasting on average 3.3 years. The incidence of cancer was reported as 6.5 per cent for ACEIs, 6.6 per cent for ARBs, 3.2 per cent for β-blockers, 6.7 per cent for diuretics, 3.9 per cent for CCBs and 3.0 per cent for placebo/control.
MTC meta-analysis found no statistically significant differences between placebo/no treatment control and ACEIs, ARBs, β-blockers, diuretics and CCBs. Individual meta-analyses for each pair-wise comparison also found no statistically significant differences between any of the drug classes compared. No significant changes to the results were reported by any of the sensitivity analyses.