Evidence map›Paper›PMID 21447663›Full record

ArticleDiabetes care2011

Risk of bladder cancer among diabetic patients treated with pioglitazone: interim report of a longitudinal cohort study.

James D Lewis, Assiamira Ferrara, Tiffany Peng, Monique Hedderson, Warren B Bilker, Charles P Quesenberry, David J Vaughn, Lisa Nessel, Joseph Selby, Brian L Strom

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01637935 (Cohort Study of Pioglitazone and Bladder Cancer in Patients With Diabetes), which is not on this map. Cited by 260 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
260citing papers in PubMed, 8 pooled it
43.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01637935 completednot on this map

Cohort Study of Pioglitazone and Bladder Cancer in Patients With Diabetes

TypeobservationalSponsorTakedaRan2004 to 2014Enrolled193,099ConditionsDiabetes, Bladder CancerArmsPioglitazone
3 · Its place in the literature

Who cites it

260 citing papers in PubMed, 8 syntheses or guidelines pooled it, 619 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pioglitazone prescription increases risk of bladder cancer in patients with type 2 diabetes: an updated meta-analysis.Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine · 2014
    Pooled it
  7. Guideline
  8. Pooled it
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Pioglitazone after Ischemic Stroke or Transient Ischemic Attack.The New England journal of medicine · 2016 · on this map
    Trial
  16. Trial
  17. Trial
  18. Review
  19. Review
  20. Article

200 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

James D LewisCenter for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia,Pennsylvania, USA. lewisjd@mail.med.upenn.edu
Assiamira Ferrara
Tiffany Peng
Monique Hedderson
Warren B Bilker
Charles P Quesenberry
David J Vaughn
Lisa Nessel
Joseph Selby
Brian L Strom
Kaiser Permanente · USUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSome preclinical in vivo studies and limited human data suggest a possible increased risk of bladder cancer with pioglitazone therapy. This is an interim report of an ongoing cohort study examining the association between pioglitazone therapy and the risk of bladder cancer in patients with diabetes. RESEARCH DESIGN AND

methodsThis study includes 193,099 patients in the Kaiser Permanente Northern California diabetes registry who were ≥40 years of age between 1997 and 2002. Those with prior bladder cancer were excluded. Ever use of each diabetes medication (defined as two or more prescriptions within 6 months) was treated as a time-dependent variable. Cox regression-generated hazard ratios (HRs) compared pioglitazone use with nonpioglitazone use adjusted for age, sex, race/ethnicity, diabetes medications, A1C, heart failure, household income, renal function, other bladder conditions, and smoking.

resultsThe group treated with pioglitazone comprised 30,173 patients. There were 90 cases of bladder cancer among pioglitazone users and 791 cases of bladder cancer among nonpioglitazone users. Overall, ever use of pioglitazone was not associated with risk of bladder cancer (HR 1.2 [95% CI 0.9-1.5]), with similar results in men and women (test for interaction P = 0.8). However, in the a priori category of >24 months of therapy, there was an increased risk (1.4 [1.03-2.0]). Ninety-five percent of cancers diagnosed among pioglitazone users were detected at early stage.

conclusionsIn this cohort of patients with diabetes, short-term use of pioglitazone was not associated with an increased incidence of bladder cancer, but use for more than 2 years was weakly associated with increased risk.

Indexed as

AdultAgedDiabetes Mellitus, Type 2FemaleHumansHypoglycemic AgentsLongitudinal StudiesMaleMiddle AgedPioglitazoneThiazolidinedionesUrinary Bladder NeoplasmsHypoglycemic AgentsPioglitazoneThiazolidinediones

Identifiers

PMID21447663
PMCPMC3064051
OpenAlexW2121264929

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.