July 10, 2012 — The Canadian Medical Association Journal (CMAJ) has published a study linking the Type-2 diabetes drug Actos (pioglitazone) to a 22% increased risk of bladder cancer. The researchers also found that cohort studies of other drugs in the thiazolidinedione class of drugs (including Avandia and Rezulin) were also associated with a 15% increased risk of bladder cancer.
The researchers analyzed pooled data collected from 10 different studies, involving more than 2.6 million patients. Of these, 3,643 had newly developed bladder cancer. Not all of the studies associated Actos with an increased risk of bladder cancer — the randomized control study found no association. However, the other studies combined associated Actos with a 22% increased risk of bladder cancer.
The researchers concluded that the evidence supports the hypothesis that thiazolidinediones, particularly Actos, increase the risk of bladder cancer among Type-2 diabetics.
In recent years, several studies have linked Actos to bladder cancer. The most recent study was published in the British Medical Journal in May, and it found that the risk of bladder cancer doubles for patients who take Actos for at least two years. In response, France and German health authorities have suspended sales of Actos. Canadian and U.S. health authorities have issued warnings that taking Actos for at least a year may increase the risk of bladder cancer by 40%.
Experts are not sure how Actos could increase the risk of bladder cancer. One theory is that the drug causes crystals to form in the bladder, which irritates the bladder. Over time, this could increase the risk of developing cancer.
Bladder cancer is one of the rarest forms of cancer, but people with Type-2 diabetes are already at a 40% increased risk of this disease. However, because the disease is so rare to begin with, even a doubled risk still translates to relatively few cases numerically.
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