Diabetes medication may increase risk of bladder cancer

July 18, 2012

The diabetes drug pioglitazone (Actos) was associated with a 22% increased risk of developing bladder cancer in a recent study, supporting earlier research findings of a link between the drug and bladder cancer.

The diabetes drug pioglitazone (Actos) was associated with a 22% increased risk of developing bladder cancer in a recent study, supporting earlier research findings of a link between the drug and bladder cancer.

In the systematic review and meta-analysis of thiazolidinediones published in the Canadian Medical Association Journal (July 3, 2012), researchers from the University of Alberta School of Public Health, Edmonton also looked at the risk associated with using rosiglitazone (Avandia). Surprisingly, they found no association between rosiglitazone and bladder cancer.

"Pioglitazone and rosiglitazone work the same way when treating diabetes, so if the risk is only there with one, there’s something different about that drug," said senior author Jeff Johnson, PhD. "And it’s also interesting to note that the increased risk with pioglitazone is really only seen in men."

Last August, the FDA approved updated drug labels for the pioglitazone-containing medicines to include safety information that the drug’s use for more than 1 year may be associated with an increased risk of bladder cancer.

Although the risk of cancer is a factor when considering treatment options, Dr. Johnson is quick to point out that the use of thiazolidinediones as a treatment has declined over the past few years because of other associated risks.

"The absolute risk of bladder cancer associated with pioglitazone was small, and there are still many other adverse effects to consider," he said. "They’re associated with fractures, fluid retention, weight gain, and heart failure. Rosiglitazone is also associated with increased risk of heart attacks.

"The importance of our research is that it can assist physicians in making better decisions about when to use pioglitazone."

The study was supported by the Canadian Institutes of Health Research.

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