https://scholars.lib.ntu.edu.tw/handle/123456789/496089
標題: | A review on thiazolidinediones and bladder cancer in human studies | 作者: | CHIN-HSIAO TSENG | 公開日期: | 2014 | 卷: | 32 | 期: | 1 | 起(迄)頁: | 1-45 | 來源出版物: | Journal of Environmental Science and Health - Part C Environmental Carcinogenesis and Ecotoxicology Reviews | 摘要: | There is a concern of an increased risk of bladder cancer associated with the use of thiazolidinediones, a class of oral glucose-lowering drugs commonly used in patients with type 2 diabetes with a mechanism of improving insulin resistance. Human studies on related issues are reviewed, followed by a discussion on potential concerns on the causal inference in current studies. Pioglitazone and rosiglitazone are discussed separately, and findings from different geographical regions are presented. Randomized controlled trials designed for primarily answering such a cancer link are lacking, and evidence from clinical trials with available data for evaluating the association may not be informative. Observational studies have been reported with the use of population-based administrative databases, single-hospital records, drug adverse event reporting system, and case series collection. Meta-analysis has also been performed by six different groups of investigators. These studies showed a signal of higher risk of bladder cancer associated with pioglitazone, especially at a higher cumulative dose or after prolonged exposure; however, a weaker signal or null association is observed with rosiglitazone. In addition, there are some concerns on the causal inference, which may be related to the use of secondary databases, biases in sampling, differential detection, and confounding by indications. Lack of full control of smoking and potential biases related to study designs and statistical approaches such as prevalent user bias and immortal time bias may be major limitations in some studies. Overlapping populations and opposing conclusions in studies using the same databases may be of concern and weaken the reported conclusions of the studies. Because randomized controlled trials are expensive and unethical in providing an answer to this cancer issue, observational studies are expected to be the main source in providing an answer in the future. Furthermore, international comparison studies using well-designed and uniform methodology to clarify the risk in specific sexes, ethnicities, and other subgroups and to evaluate the interaction with other environmental risk factors or medications will be helpful to identify patients at risk. ? 2014 Copyright ? Taylor & Francis Group, LLC. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84896791958&doi=10.1080%2f10590501.2014.877645&partnerID=40&md5=f8e9045115a655611beda5c0f2f5453d https://scholars.lib.ntu.edu.tw/handle/123456789/496089 |
ISSN: | 1059-0501 | DOI: | 10.1080/10590501.2014.877645 | SDG/關鍵字: | Bladder cancers; Epidemiological studies; Pioglitazone; Rosiglitazone; Thiazolidinediones; Type-2 diabetes; Biographies; Database systems; Diseases; 2,4 thiazolidinedione derivative; pioglitazone; rosiglitazone; Asia; bladder cancer; cancer risk; case control study; cohort analysis; control; data base; diabetes mellitus; disease association; drug exposure; Europe; France; general practice; hospital based case control study; human; India; Japan; Korea; long term exposure; medical society; national health insurance; nonhuman; North America; observational study; propensity score; prostate hypertrophy; review; risk assessment; Taiwan; United Kingdom; Humans; Hypoglycemic Agents; Meta-Analysis as Topic; Thiazolidinediones; Urinary Bladder Neoplasms |
顯示於: | 醫學系 |
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