近年来在癌症领域中重新利用已经获得批准的药物越来越受到关注。曲纳沙通是一种抗纤溶药物，由于动物研究显示其具有抗炎和抗癌作用，因此最近被建议作为一种抗癌药物。在这项研究中，我们旨在调查曲纳沙通在丹麦女性中可能具有的黑色素瘤预防作用。在这个嵌套病例对照研究中，我们识别了2000-2015年首次患黑色素瘤的18-60岁女性病例，并将其与10个女性对照进行年龄匹配。使用条件 logistic 回归估计曲纳沙通已使用或高剂量使用（≥ 100,000mg）与黑色素瘤的比值比（OR）。 共有7986名患有发病性黑色素瘤的女性符合研究纳入条件，并与79,860名对照进行匹配。大多数接触过曲纳沙通的病例和对照都接触过低剂量的累计用量，相当于约连续治疗5天（每日3次1000mg）的假定主要适应症——月经过多。曲纳沙通使用与黑色素瘤的原始 OR 为1.04（95% CI 0.98-1.11，p = 0.20），调整后的 OR 为1.03 (0.97-1.10，p = 0.32)。我们没有发现用药剂量与年龄、组织学类型、定位或临床分期之间的剂量-反应模式或效应测量修改。但是，曲纳沙通的长期使用（≥ 100,000mg的累计剂量）与黑色素瘤的风险增加有关（调整 OR 1.23，95% CI 0.96-1.56），与非使用相比。 我们没有发现曲纳沙通使用与丹麦女性黑色素瘤的风险有关。这可能是由于潜在的剂量或生物因素以及零散使用模式。长期使用者的患黑色素瘤的风险更高，这可能是由于监控偏倚所致。版权所有©2023 Elsevier Ltd。保留所有权利。

Repurposing already approved drugs in a cancer setting has gained increasing interest in recent years. Tranexamic acid is an anti-fibrinolytic drug that has recently been suggested as an anti-cancer drug due to its anti-inflammatory and anti-carcinogenic effects in animal studies. In this study, we aimed to investigate the possible melanoma-preventive role of tranexamic acid in Danish women.In this nested case-control study, we identified female cases 18-60 years with first-time melanoma during 2000-2015 and age-matched them with 10 female controls. The odds ratio (OR) of melanoma with tranexamic acid ever- or high use (≥ 100,000 mg) was estimated using conditional logistic regression.A total of 7986 women with incident melanoma were eligible for study inclusion and were matched to 79,860 controls. Most exposed cases and controls were exposed to low cumulative doses of tranexamic acid corresponding to around 5 days of continuous treatment (1000 mg 3 times daily) for the presumed main indication, i.e., menorrhagia. The crude OR associating tranexamic ever use with melanoma was 1.04 (95% CI 0.98-1.11, p = 0.20), and the adjusted OR was 1.03 (0.97-1.10, p = 0.32). We found no dose-response pattern or effect measure modification by age, histologic type, localization, or clinical stage. However, prolonged use with cumulative doses of tranexamic acid (≥ 100,000 mg) was associated with an increased risk of melanoma (adjusted OR 1.23,95 %, CI 0.96-1.56), compared with non-use.We found no association between tranexamic acid use and the risk of melanoma in Danish women. This could be explained by underlying dose- or biological factors, and sporadic use patterns. A higher risk of melanoma was seen among prolonged users which could be due to surveillance bias.Copyright © 2023 Elsevier Ltd. All rights reserved.