Evidence map›Paper›PMID 24325197›Full record

SynthesisBritish journal of clinical pharmacology2014

Thiazolidinediones and associated risk of bladder cancer: a systematic review and meta-analysis.

Richard M Turner, Chun S Kwok, Chen Chen-Turner, Chinedu A Maduakor, Sonal Singh, Yoon K Loke

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 3 pooled it
7.6field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 127 citations in OpenAlex.

  1. Pooled it
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  3. Thiazolidinediones and risk of colorectal cancer in patients with diabetes mellitus: A meta-analysis.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
    Pooled it
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  16. Observational
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  19. Epidemiology, aetiology and screening of bladder cancer.Translational andrology and urology · 2019
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Richard M TurnerDepartment of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK; Royal Liverpool University Hospital, Liverpool, UK.
Chun S Kwok
Chen Chen-Turner
Chinedu A Maduakor
Sonal Singh
Yoon K Loke
University of East Anglia · GBJohns Hopkins Medicine · USRoyal Liverpool University Hospital · GBUniversity of Liverpool · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo determine whether thiazolidinedione use is associated with a risk of bladder cancer.

methodsWe searched MEDLINE and EMBASE in June 2012 (with PubMed update to July 2013) and conducted meta-analysis on the overall risks of bladder cancer with pioglitazone or rosiglitazone and the risk with different categories of cumulative dose or duration of drug use.

resultsWe screened 230 citations and included 18 studies, comprising five randomized controlled trials (RCTs) and 13 observational studies. Meta-analysis showed a significantly higher overall risk of bladder cancer with pioglitazone in RCTs [7878 participants; odds ratio (OR) 2.51, 95% confidence interval (CI) 1.09-5.80] and observational studies (>2.6 million patients; OR for 'ever' users vs. non-users 1.21, 95% CI 1.09-1.35). Subgroup analysis of observational studies by cumulative dose showed the risk of bladder cancer to be greatest with >28.0 g of pioglitazone (OR 1.64, 95% CI 1.28-2.12). A significantly increased risk was found with both 12-24 months (OR 1.41, 95% CI 1.16-1.71) and >24 months (OR 1.51, 95% CI 1.26-1.81) cumulative durations of pioglitazone exposure. No significant risk was seen with rosiglitazone in RCTs (OR 0.84, 95% CI 0.35-2.04) or 'ever' users vs. non-users in observational studies (OR 1.03, 95% CI 0.94-1.12); the evidence for any relationship between bladder cancer risk and rosiglitazone cumulative duration is limited and inconsistent. Direct comparison of pioglitazone to rosiglitazone 'ever' users yielded an OR of 1.25 (95% CI 0.91-1.72).

conclusionsA modest but clinically significant increase in the risk of bladder cancer with pioglitazone was found, which appears to be related to cumulative dose and duration of exposure. We recommend that prescribers limit pioglitazone use to shorter durations.

Indexed as

Data Interpretation, StatisticalDose-Response Relationship, DrugHumansRiskThiazolidinedionesUrinary Bladder NeoplasmsThiazolidinedionesdiabetes mellitusmeta-analysispioglitazonerosiglitazonethiazolidinedioneurinary bladder neoplasm

Identifiers

PMID24325197
PMCPMC4137819
OpenAlexW1752522506

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.