VA Research Wrap Up: New findings on skin cancer, hypertension and stimulant use disorder

This week, VA’s Office of Research and Development published three News Briefs highlighting research advances on skin cancer prevention, hypertension treatment guidelines and stimulant use disorder treatment.

Vitamin B3 may lower skin cancer risk

An over-the-counter form of vitamin B3, nicotinamide, was found to reduce overall skin cancer reoccurrence by 14% – 54% if started after the first skin cancer diagnosis.

A team of Tennessee Valley VA and Vanderbilt University researchers conducted the retrospective study, which included more than 34,000 Veterans diagnosed at least once with skin cancer, approximately half of whom received 500 mg of vitamin B3 twice daily. Using the Veterans’ electronic medical record, the researchers tracked whether the Veterans received another skin cancer diagnosis from 1999 to 2024. The number of skin cancer diagnoses the patient had before starting B3 significantly influenced the rate of future diagnoses. Starting treatment after the first diagnosis showed the most significant effect, with the benefits declining with each subsequent diagnosis. After the seventh diagnosis, there was no significant effect. The risk reduction was greatest for cutaneous squamous cell carcinoma and basal cell carcinoma, the two most common types of skin cancer. View the full study at “JAMA Dermatology.”

VA’s hypertension guidelines are often not followed

In the 1980s and 90s, beta blockers were the first line of treatment for high blood pressure, but research partially conducted in VA led to new hypertension treatment guidelines in 2014 that stated beta blockers should not be the first treatment choice except in narrow circumstances. VA Salt Lake City and University of Utah researchers explored more than three million Veteran records and learned of nearly 775,000 Veterans prescribed beta blockers, almost 90% did not meet the guidelines as of 2022. Veterans who were older, female or non-Hispanic Whites had higher rates of beta-blocker first-line prescription. The findings suggest the need for interventions to improve adherence to recommended hypertension treatment. View the full study at “JAMA Network Open.”

New incentive could reduce death from stimulant use

Stimulant use disorder contributes to more than 50% of overdose deaths in the U.S., but a study by Ann Arbor VA researchers and the University of Michigan recently discovered contingency management therapy could lower the risk of death by 41% after just one year. Contingency management uses monetary incentives such as cash or gift certificates to motivate patients to maintain drug-free urine screens and attend treatment sessions. The study included 3,000 Veterans diagnosed with stimulant use disorder, half of whom received contingency management between 2018 and 2020. While deaths were lower in the contingency management group, both medical and psychiatric hospitalizations were slightly higher. This may indicate a need for stronger treatment engagement. Currently, there are no FDA-approved medication-based treatments for stimulant use disorder. These findings provide the first real-world evidence that contingency management can reduce death in this difficult-to-treat population. View the full study at the “American Journal of Psychiatry.”

For more Office of Research and Development updates, visit ORD online or go to https://www.research.va.gov/news_briefs/.