We recommend prescribers limit pioglitazone use to shorter durations.
Raleigh, NC (PRWEB) February 17, 2014
The authors of a new study published in the British Journal of Clinical Pharmacology and detailed by Cancer Monthly recommend that doctors who treat diabetes limit their patients’ exposure to the drug piaglitazone (Actos) to reduce their risk of bladder cancer.
The research team from Liverpool conducted a search of the medical literature for any studies linking pioglitazone with bladder cancer. They found 230 citations, including 18 studies. Five of the studies were randomized controlled trials and 13 were observational studies. The randomized controlled trials included 7,878 participants and the observational studies included more than 2.6 million. Meta-analysis showed a “significantly higher overall risk of bladder cancer” with pioglitazone use in both types of studies.
Further analysis showed that the risk of bladder cancer among diabetics increased with higher doses and/or longer duration of pioglitazone treatment. The risk of bladder cancer was greatest in diabetics on more than 28 grams of pioglitazone. A “significant increased risk” of bladder cancer was also found among patients who were on pioglitazone for a year or more.
Notably, the researchers did not find the same bladder cancer risk with a similar drug called rosiglitazone (Avandia), which is in the same drug category as pioglitazone but was withdrawn because of its association with cardiovascular problems. They conclude that the evidence for a relationship between bladder cancer risk and rosiglitazone is “limited and inconsistent”.
In an effort to limit the bladder cancer risk potential of pioglitazone, the researchers conclude their article with a recommendation that prescribers “limit pioglitazone use to shorter durations”. The drug has been withdrawn as a diabetes treatment in some countries because of the risk. The original research article appears in the British Journal of Clinical Pharmacology. (Turner, RM, et al, “Thiazolidinediones and associated risk of bladder cancer: a systematic review and meta-analysis”, December, 2013, British Journal of Clinical Pharmacology, Epub ahead of print, http://www.ncbi.nlm.nih.gov/pubmed/24325197)
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