Pioglitazone use and risk of bladder cancer: population based cohort study

Objective To determine whether pioglitazone compared with other antidiabetic drugs is associated with an increased risk of bladder cancer in people with type 2 diabetes.Design Population based cohort study.Setting General practices contributing data to the United Kingdom Clinical Practice Research D...

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Vydáno v:BMJ (Online) Ročník 352; s. i1541
Hlavní autoři: Tuccori, Marco, Filion, Kristian B, Yin, Hui, Yu, Oriana H, Platt, Robert W, Azoulay, Laurent
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ Publishing Group LTD 30.03.2016
BMJ Publishing Group Ltd
Témata:
Bias
Bladder cancer
Cohort Studies
Confidence intervals
Diabetes
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - epidemiology
Dictionaries
Drug dosages
Excretory system
Family medical history
Fashion models
Female
General Practice - statistics & numerical data
Health risk assessment
Humans
Hypoglycemic Agents - adverse effects
Insulin
Male
Middle Aged
Pioglitazone
Risk Factors
Rosiglitazone
Studies
Substance abuse treatment
Thiazolidinediones - adverse effects
United Kingdom - epidemiology
Urinary Bladder Neoplasms - chemically induced
Urinary Bladder Neoplasms - epidemiology
United Kingdom > UK
ISSN:1756-1833, 0959-8138, 1756-1833
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Shrnutí:Objective To determine whether pioglitazone compared with other antidiabetic drugs is associated with an increased risk of bladder cancer in people with type 2 diabetes.Design Population based cohort study.Setting General practices contributing data to the United Kingdom Clinical Practice Research Datalink.Participants A cohort of 145 806 patients newly treated with antidiabetic drugs between 1 January 2000 and 31 July 2013, with follow-up until 31 July 2014.Main outcome measures The use of pioglitazone was treated as a time varying variable, with use lagged by one year for latency purposes. Cox proportional hazards models were used to estimate adjusted hazard ratios with 95% confidence intervals of incident bladder cancer associated with pioglitazone overall and by both cumulative duration of use and cumulative dose. Similar analyses were conducted for rosiglitazone, a thiazolidinedione not previously associated with an increased risk of bladder cancer.Results The cohort generated 689 616 person years of follow-up, during which 622 patients were newly diagnosed as having bladder cancer (crude incidence 90.2 per 100 000 person years). Compared with other antidiabetic drugs, pioglitazone was associated with an increased risk of bladder cancer (121.0 v 88.9 per 100 000 person years; hazard ratio 1.63, 95% confidence interval 1.22 to 2.19). Conversely, rosiglitazone was not associated with an increased risk of bladder cancer (86.2 v 88.9 per 100 000 person years; 1.10, 0.83 to 1.47). Duration-response and dose-response relations were observed for pioglitazone but not for rosiglitazone.Conclusion The results of this large population based study indicate that pioglitazone is associated with an increased risk of bladder cancer. The absence of an association with rosiglitazone suggests that the increased risk is drug specific and not a class effect.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1756-1833
0959-8138
1756-1833
DOI:10.1136/bmj.i1541