POEMs

Pioglitazone Exposure Increases Bladder Cancer Risk



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Am Fam Physician. 2014 Jan 15;89(2):136.

Clinical Question

Do adults with type 2 diabetes mellitus who are treated with pioglitazone (Actos) have an increased risk of bladder cancer?

Bottom Line

This review of all available data found a significantly increased risk of bladder cancer among adults with type 2 diabetes treated with pioglitazone. Pioglitazone also significantly increases the risk of heart failure, and there is minimal, if any, patient-oriented evidence of benefit from treatment (Richter B, Bandeira-Echtler E, Bergerhoff K, Clar C, Ebrahim SH. Cochrane Database Syst Rev. 2006; [4]:CD006060). The French and German governments have suspended or strongly curtailed the use of pioglitazone. It lowers A1C levels, but I would not want my loved ones taking this stuff. (Level of Evidence = 2b)

Synopsis

Because of concern that pioglitazone is associated with an increased

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

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