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A systematic review of observational studies of the association between pioglitazone use and bladder cancer
Author(s) -
Ripamonti E.,
Azoulay L.,
Abrahamowicz M.,
Platt R.W.,
Suissa S.
Publication year - 2019
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13854
Subject(s) - observational study , medicine , pioglitazone , meta analysis , bladder cancer , medline , incidence (geometry) , research design , intensive care medicine , type 2 diabetes , cancer , diabetes mellitus , endocrinology , statistics , physics , mathematics , optics , political science , law
Aim To conduct a systematic review of all observational studies on the effect of pioglitazone on the risk of bladder cancer. Methods The MEDLINE and EMBASE databases were queried for papers published between 1 January 2000 and 30 October 2017. We took into consideration observational studies (both retrospective and prospective) that included participants with Type 2 diabetes prescribed anti‐hyperglycaemic drugs. Results While some studies reported an association, others did not, and meta‐analyses of these studies showed a significantly increased risk; however, while meta‐analysis is a powerful and practical statistical tool, its results should be considered with caution when applied to widely heterogeneous studies. We describe how many of these studies are affected by different types of bias, most notably time‐related biases, which should preclude a pooled analysis that would result in biased estimation of the risk. Conclusions Given existing data, it is not appropriate to pool the outcomes of highly heterogeneous studies and further rigorously conducted observational research is needed to clarify the role of pioglitazone use on the incidence of bladder cancer.