Pioglitazone and Risk of Chronic Obstructive Pulmonary Disease in Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study

Tseng, Chin‐Hsiao

doi:10.2147/copd.s345796

Cited by 9 publications

(8 citation statements)

References 36 publications

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“…First, together with our previous studies that do not suggest an increased risk of bladder cancer [ 30 ], ovarian cancer [ 31 ], oral cancer [ 32 ], kidney cancer [ 33 ], thyroid cancer [ 34 ], lung cancer [ 35 ] and prostate cancer [ 36 ] associated with pioglitazone use, the public health concern of an increased cancer risk associated with pioglitazone can be relieved and should not impede the clinical use of pioglitazone. Second, the potential benefits of pioglitazone on the improvement of lipid profile [ 37 ], the risk reduction of dementia [ 38 , 39 ], chronic obstructive pulmonary disease [ 40 ], non-alcoholic fatty liver disease [ 41 ], stroke [ 2 ] and cardiovascular disease [ 42 ] and the usefulness of pioglitazone in the treatment of polycystic ovarian syndrome in women [ 43 ] suggest that some patients may gain pleiotropic benefits beyond glycemic control from the appropriate use of pioglitazone.…”

Section: Discussionmentioning

confidence: 99%

Pioglitazone and breast cancer risk in female patients with type 2 diabetes mellitus: a retrospective cohort analysis

Tseng

2022

BMC Cancer

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Background Whether pioglitazone may affect breast cancer risk in female diabetes patients is not conclusive and has not been investigated in the Asian populations. Methods The reimbursement database of Taiwan’s National Health Insurance was used to enroll an unmatched cohort and a propensity score-matched cohort of ever users and never users of pioglitazone in female patients with newly diagnosed type 2 diabetes during 1999–2008. The patients were alive on January 1, 2009 and were followed up for breast cancer incidence until December 31, 2011. Cox regression was used to estimate hazard ratios for ever users and tertiles of cumulative duration of pioglitazone therapy versus never users, and for cumulative duration of pioglitazone therapy treated as a continuous variable. Three models were created for the unmatched cohort and the matched cohort, respectively: 1) without adjustment for covariates; 2) after adjustment for covariates that differed with statistical significance (P-value < 0.05) between ever users and never users; and 3) after adjustment for all covariates. Results There were 174,233 never users and 6926 ever users in the unmatched cohort; and 6926 never users and 6926 ever users in the matched cohort. After a median follow-up of 2.8 years, the numbers of incident breast cancer were 1044 in never users and 35 in ever users in the unmatched cohort and were 41 and 35, respectively, in the matched cohort. Hazard ratios suggested a null association between pioglitazone and breast cancer in all three models in either the unmatched cohort or the matched cohort. The overall hazard ratio after adjustment for all covariates was 0.758 (95% confidence interval: 0.539–1.065) in the unmatched cohort and was 0.824 (95% confidence interval: 0.524–1.296) in the matched cohort. None of the hazard ratios for the tertiles of cumulative duration of pioglitazone therapy and for the cumulative duration being treated as a continuous variable were statistically significant. Conclusions This study suggests a null association between pioglitazone and breast cancer risk in female patients with type 2 diabetes mellitus. However, because of the small breast cancer cases and the limited follow-up time, further studies are warranted to confirm our findings.

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Section: Discussionmentioning

confidence: 99%

Pioglitazone and breast cancer risk in female patients with type 2 diabetes mellitus: a retrospective cohort analysis

Tseng

2022

BMC Cancer

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“… 168 This conclusion supports previous documentation that thiazolidinedione exposure was associated with a slight but substantial decrease in the incidence of COPD exacerbation in adults with diabetes and concurrent COPD. 169 Interestingly, a cohort-based case-control study using data from Taiwan’s National Health Insurance Research Database found that thiazolidinedione combination medications were associated with a lower incidence of AECOPD in patients with advanced T2DM and coexisting COPD. 170 Patients who received sulfonylurea and thiazolidinedione had a lower risk of AECOPD than those who received metformin and sulfonylurea, and those who received metformin, sulfonylurea, and thiazolidinedione had a lower risk of AECOPD than a combination of metformin, sulfonylurea, and α-glucosidase inhibitors, regardless of COPD complexity.…”

Section: Type 2 Diabetes Mellitusmentioning

confidence: 99%

Cardiovascular diseases or type 2 diabetes mellitus and chronic airway diseases: mutual pharmacological interferences

Cazzola

Rogliani

Ora

et al. 2023

Therapeutic Advances in Chronic Disease

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Chronic airway diseases (CAD), mainly asthma and chronic obstructive pulmonary disease (COPD), are frequently associated with different comorbidities. Among them, cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) pose problems for the simultaneous treatment of CAD and comorbidity. Indeed, there is evidence that some drugs used to treat CAD negatively affect comorbidity, and, conversely, some drugs used to treat comorbidity may aggravate CAD. However, there is also growing evidence of some beneficial effects of CAD drugs on comorbidities and, conversely, of the ability of some of those used to treat comorbidity to reduce the severity of lung disease. In this narrative review, we first describe the potential cardiovascular risks and benefits for patients using drugs to treat CAD and the potential lung risks and benefits for patients using drugs to treat CVD. Then, we illustrate the possible negative and positive effects on T2DM of drugs used to treat CAD and the potential negative and positive impact on CAD of drugs used to treat T2DM. The frequency with which CAD and CVD or T2DM are associated requires not only considering the effect that drugs used for one disease condition may have on the other but also providing an opportunity to develop therapies that simultaneously favorably impact both diseases.

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“…PPARG is a key regulator of fetal lung maturation (Lee et al, 2020 ), lung immunity (Nobs & Kopf, 2018 ), fibrosis (Deng et al, 2012 ), vasculature (Hart, 2008 ), and metabolism (Kökény et al, 2021 ), etc. PPARG is a promising target in lung pathologies such as chronic airway inflammation (Belvisi et al, 2006 ), asthma and COPD (Al Sharif, 2021 ; Byelan et al, 2017 ; Rogliani et al, 2018 ; Tseng, 2022 ), pulmonary vascular disease (Afdal & AbdelMassih, 2018 ), pulmonary artery hypertension (Hansmann et al, 2020 ), fibrosis (Milam et al, 2008 ), and cancer (Li et al, 2006 ). Activation of PPARG is a possible tool for the realization of pleiotropic effects.…”

Section: Introductionmentioning

confidence: 99%

PPARG stimulation restored lung mRNA expression of core clock, inflammation‐ and metabolism‐related genes disrupted by reversed feeding in male mice

Shlykova,

Izmailova,

Kabaliei

et al. 2023

Physiological Reports

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The circadian rhythm system regulates lung function as well as local and systemic inflammations. The alteration of this rhythm might be induced by a change in the eating rhythm. Peroxisome proliferator‐activated receptor gamma (PPARG) is a key molecule involved in circadian rhythm regulation, lung functions, and metabolic processes. We described the effect of the PPARG agonist pioglitazone (PZ) on the diurnal mRNA expression profile of core circadian clock genes (Arntl, Clock, Nr1d1, Cry1, Cry2, Per1, and Per2) and metabolism‐ and inflammation‐related genes (Nfe2l2, Pparg, Rela, and Cxcl5) in the male murine lung disrupted by reversed feeding (RF). In mice, RF disrupted the diurnal expression pattern of core clock genes. It decreased Nfe2l2 and Pparg and increased Rela and Cxcl5 expression in lung tissue. There were elevated levels of IL‐6, TNF‐alpha, total cells, macrophages, and lymphocyte counts in bronchoalveolar lavage (BAL) with a significant increase in vascular congestion and cellular infiltrates in male mouse lung tissue. Administration of PZ regained the diurnal clock gene expression, increased Nfe2l2 and Pparg expression, and reduced Rela, Cxcl5 expression and IL‐6, TNF‐alpha, and cellularity in BAL. PZ administration at 7 p.m. was more efficient than at 7 a.m.

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Pioglitazone and Risk of Chronic Obstructive Pulmonary Disease in Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study

Cited by 9 publications

References 36 publications

Pioglitazone and breast cancer risk in female patients with type 2 diabetes mellitus: a retrospective cohort analysis

Pioglitazone and breast cancer risk in female patients with type 2 diabetes mellitus: a retrospective cohort analysis

Cardiovascular diseases or type 2 diabetes mellitus and chronic airway diseases: mutual pharmacological interferences

PPARG stimulation restored lung mRNA expression of core clock, inflammation‐ and metabolism‐related genes disrupted by reversed feeding in male mice

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