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Dose effect of thiazolidinedione on cancer risk in type 2 diabetes mellitus patients: a six‐year population‐based cohort study
Author(s) -
Lin H. C.,
Hsu Y. T.,
Kachingwe B. H.,
Hsu C. Y.,
Uang Y. S.,
Wang L. H.
Publication year - 2014
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12151
Subject(s) - medicine , hazard ratio , oncology , thiazolidinedione , population , proportional hazards model , type 2 diabetes , cancer , diabetes mellitus , endocrinology , confidence interval , environmental health
Summary What is known and objective Prior studies found that thiazolidinediones ( TZD s) might have tumour‐suppressor activity mediated through cell‐cycle arrest, induction of apoptosis and inhibition of cell invasion. The main objective of this study was to investigate the effects of TZD s on the risk of cancer among patients with type 2 diabetes mellitus ( DM ). Methods Patients diagnosed with DM between 1 January 1998 and 31 December 2002 were identified from the Longitudinal Health Insurance Database (LHID) within the Taiwan National Health Insurance ( NHI ) programme. Using Cox regression models, we assessed the association between prescribed TZD s and cancer risk, TZD s' dose effect and the association between TZD s and specific cancer types. Hazard ratios ( HR ) were adjusted for potential confounders (age, gender, income, Charlson score index, metformin and insulin use). Results and discussion The adjusted HR s for those prescribed TZD were 0·74 (95% CI 0·43–1·26, P = 0·27), 0·39 (95% CI 0·33–0·45, P < 0·001) and 0·49 (95% CI 0·27–0·89, P = 0·02), respectively, relative to non‐ DM patients, DM patients prescribed other anti‐ DM drugs besides TZD s and DM patients not prescribed any anti‐ DM drugs. In addition, the effects of TZD s were shown to be significantly dose dependent ( P for trend < 0·001). The risk of breast, brain, colorectal, ear–nose–throat, kidney, liver, lung, lymphatic, prostate, stomach, and uterus cancer was significantly lower in those prescribed TZD s. What is new and conclusions The results showed a decrease in cancer risk in diabetic patients using TZD , and the association was dose dependent.