July 10, 2012 — Another study is adding to the evidence that Actos (pioglitazone), a popular Type-2 diabetes drug, may increase the risk of bladder cancer. A new study published in the July 3 edition of the Canadian Medical Association Journal has linked Actos to a 22% increased risk of bladder cancer, and the entire thiazolidinedione class to a 15% higher chance of developing bladder cancer.
The researchers chose 10 separate studies, pooled the data from these studies, and then conducted a meta-analysis to look for trends. The combined studies involved more than 2.6 million people, of whom 3,643 suffered from newly-developed bladder cancer.
Actos was not associated with bladder cancer in all the studies — one study, a randomized control study, found no association between Actos and bladder cancer. When the other studies were combined, however, Actos was associated with a 22% increased risk.
In conclusion, the researchers said that the evidence from their analysis supports the hypothesis that Actos and other thiazolidinedines increase a Type-2 diabetic person’s chance of getting bladder cancer.
The researchers’ study comes on the heels of several other studies linking Actos to bladder cancer. Most recently, the British Medical Journal published a study in May 2012 linking Actos to a doubled risk of bladder cancer when the drug is taken for two years. In 2011, another study found that using Actos for one year increased the risk of bladder cancer by 40%. These studies prompted France and German officials to restrict sales of Actos. The U.S. FDA and Canadian health officials issued warnings and updated the labels on Actos.
The study does not make it clear exactly how Actos affects the bladder. Experts have hypothesized that the ingredients in Actos could cause small crystals to form in the bladder. These tiny crystals may cause a low-level bladder irritation, which, over time, may increase the risk of bladder cancer. However, it is unknown exactly how Actos could cause bladder cancer.
People who have Type-2 diabetes already have an approximately 40% greater risk of developing bladder cancer, compared to people who do not have Type-2 diabetes. However, numerically, the risk is still small — this is because bladder cancer is a very rare cancer.
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