Diabetes patients taking thiazolidinedione (TZDs) drugs to help lower improve insulin sensitivity are at greater risk of developing bladder cancer, according to a new study which casts further doubt on their safety.
Researchers from the Perelman School of Medicine at the University of Pennsylvania analysed 60,000 type 2 diabetes patients and found that those treated with the already controversial TZD drugs rosiglitzaone (Avandia) or pioglitazone (Actos) for at least five years were two to three times more likely to develop bladder cancer compared to those who took sulfonylureas – another common class of diabetes medicines.
Among the TZD-taking group, the results indicated that 170 patients per 100,000 would be expected to develop the disease, compared to around 60 in 100,000 of those using glipizide (Glucotrol) and other sulfonylurea drugs. Among the generation population, bladder cancer affects around 30 in 100,000 people.
Actos has previously been linked with an increased risk of bladder cancer, leading to the drug being pulled from various retail markets. However, the researchers reported that the risk of bladder cancer appeared to be common among both drugs in the TZD class.
“The fact that we have compared bladder cancer risk among patients taking each of those drugs provides essential information, because a safety warning on a drug is only useful to a doctor when they have knowledge of the same risks for an alternative drug,” lead author, Ronac Mamtani, MD, said.
“We believe our study will help doctors and their patients weigh the potential benefits and risks when selecting between different diabetes medications .”
The research was published online in the Journal of the National Cancer Institute.

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