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Pioglitazone and risk of bladder cancer: a meta-analysis of controlled studies.
MedLine Citation:
PMID:  23350856     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Pioglitazone, a thiazolidinedione, was approved for treatment of Type 2 diabetes. However, several observational studies suggest an association of pioglitazone with an increased risk of bladder cancer in patients with diabetes. Therefore, we sought to perform a systematic review and meta-analysis to evaluate the magnitude of this association and the quality of the supporting evidence. RESEARCH DESIGN AND METHODS: Electronic databases were queried to identify controlled studies of pioglitazone that measured the risk of bladder cancer. RESULTS: Six studies involving 215 142 patients using pioglitazone were included, with a median period of follow-up of 44 months. The hazard of developing bladder cancer was significantly higher in patients using pioglitazone (hazard ratio 1.23; 95% CI 1.09-1.39; I(2)  = 0%) compared with control groups. The risk of bias was moderate across the six studies. Considering an incidence rate of 20.8 per 100 000 person years, the number needed to harm was five additional cases of bladder cancer per 100 000 person years. CONCLUSION: Pioglitazone use is associated with an increased risk of bladder cancer. Clinicians must consider this increased risk in the context of the baseline risk for bladder cancer of their patients, other adverse features of this medicine (e.g. weight gain, cost) and its potential anti-hyperglycaemic benefits. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.
Authors:
M Ferwana; B Firwana; R Hasan; M H Al-Mallah; S Kim; V M Montori; M H Murad
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-28
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  -     ISSN:  1464-5491     ISO Abbreviation:  Diabet. Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.
Affiliation:
National and Gulf Center for Evidence Based Health Practice, King Saud bin Abdulaziz University for Health Sciences; Family Medicine and Primary Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
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