A retrospective study on finding correlation of pioglitazone and incidences of bladder cancer in the Indian population

Abstract

Objectives:This retrospective cohort study analyzed the clinical data of cancer patients conducted in a cancer hospital, Chennai to assess the correlation (if any) between use of antidiabetic agents including pioglitazone and the incidence of bladder cancer.Materials and Methods:Totally, 5079 cancer patients’ with and without diabetes were included and analyzed in this retrospective study.Results:A total of 1077 patient data were screened out of a total of 5079. A total of 20 patients were found to have bladder cancer. Out of 1077 patients, 31 were pioglitazone users on the drug for not less than 2 years. The remaining 1046 were on other drugs other than pioglitazone. It is observed that 1 out of 31 developed bladder cancer in the pioglitazone group 19 out of 1046 developed bladder cancer in the nonpioglitazone group. The result of the analysis indicates that there is no significant (P = 0.918) association between pioglitazone and bladder cancer.Conclusion:In this retrospective study, the number of diabetic patients on pioglitazone with bladder cancer was fewer than the diabetic patients on other medications with the disease. Further, no link could be established between any specific drug use and bladder cancer. Least number of patients with bladder cancer was on pioglitazone, suggesting that pioglitazone alone cannot be considered a cause for increased incidence of bladder cancer in diabetic patients.

Activity and molecular targets of pioglitazone via blockade of proliferation, invasiveness and bioenergetics in human NSCLC

“…The pro-apoptotic effect of pioglitazone was also confirmed by labeling with annexin V and subsequent protein expression analysis observing an increase in caspase-3 and a reduction in survivin, pro-apoptosis and pro-survival markers, respectively. Some of TGFβ oncogenic activities are linked to its induction of a phenotypic switch known as the EMT, in which cell adhesions are disrupted, the surrounding matrix is degraded, and the tumor cells become more motile and invasive, thereby increasing their metastatic potential [22]. The over expression of TGFβ ligands has been reported in most tumor types, and elevated levels of these ligands in tumor tissues or in patient serum correlates with more metastatic phenotypes or poorer patient outcome [23].…”

Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes

“…Thiazolidinediones Earlier concerns that the thiazolidinediones (TZDs)-in particular pioglitazone-are associated with bladder cancer have largely been allayed by subsequent evidence [23][24][25]. These agents tend to cause weight gain and peripheral oedema and have been shown to increase the incidence of heart failure [26].…”

Pioglitazone utilization, efficacy & safety in Indian type 2 diabetic patients: A systematic review & comparison with European Medicines Agency Assessment Report

“…No significant association was found between pioglitazone use and bladder cancer72. In comparison, KPNC study (USA) which included 193,099 diabetic patients found significant risk of bladder cancer in pioglitazone exposed patients with cumulative dose more than 28,000 mg and cumulative duration more than two years8.…”