Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

USE OF THIAZOLIDINEDIONES AND RISK OF BLADDER CANCER: DISEASE OR DRUGS?

Author

M.T. Bazelier

Institution

Utrecht University

Abstract

Objectives: To evaluate the risk of bladder cancer in diabetic patients according to thialozidinedione (TZD) treatment and other antidiabetic use.

Methods: We conducted a population-based cohort study (1996-2007) utilizing the Danish National Health Registers. Oral antidiabetic users (n=179,056) were matched by age and sex to non- users. Cox proportional hazards models were used to estimate hazard ratios (HRs) of bladder cancer. Four different treatment stages were defined: stage 1 was defined as current use of either a biguanide or a sulfonylureum, stage 2 as current use of a biguanide and a sulfonylureum at the same time, stage 3 was assigned to patients using TZDs and stage 4 to patients using insulin.

Results: Compared with non-diabetic controls, patients using antidiabetic medication experienced a 1.3-fold increased risk of bladder cancer (adjusted HR 1.3 [95%CI 1.2-1.4]). No major differences were observed between the different treatment stages. The risk of bladder cancer varied between 1.2 [1.0-1.4] in stage 4 and 1.4 [1.3-1.6] in stage 1. The risk of bladder cancer with TZD use (stage 3) was similar to the other groups (adjusted HR 1.3 [0.6-2.7]).

Conclusion: Our results do not support that patients should discontinue taking TZDs because of an increased risk of bladder cancer.