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But the absolute risk of getting the cancer is small, researchersfind. By Steven Reinberg HealthDay Reporter THURSDAY, May 31 (HealthDay News) -- People with type 2 diabetestaking Actos (pioglitazone) to control blood sugar may putthemselves at risk for bladder cancer, according to a new Canadianstudy. Although the absolute risk of anyone developing bladder cancerremains very low, taking the Actos pill for two years can doublethe risk, the researchers said. "We believe physicians, patients and regulatory agencies should beaware of this association when assessing the overall risks andbenefits of this therapy," said lead researcher Laurent Azoulay,from the Center for Clinical Epidemiology at the Lady DavisInstitute at Jewish General Hospital in Montreal. "The association between the use of pioglitazone and bladder canceris controversial, with several studies reporting conflictingresults, from modest increased risks to no association," saidAzoulay, who also is an assistant professor in the oncologydepartment at McGill University in Montreal. The report was published online May 31 in the journal BMJ . This is not the first time the drug has been linked to bladdercancer. In 2011, the U.S. Food and Drug Administration required thedrug maker, Takeda Pharmaceuticals North America, to add a warningof the risk of bladder cancer to the drug's label. Actos's sister drug, Avandia (rosiglitazone), has been linked toincreased heart risks. Both drugs are in a class of drugs calledthiazolidinediones that help control blood sugar levels in patientswith type 2 diabetes. Avandia was not associated with an increasedrisk of bladder cancer in this study. For this study, Azoulay's team collected data on nearly 116,000people treated for diabetes from 1988 to 2009 and listed in theGeneral Practice Research Database, which contains records frommore than 600 medical offices in the United Kingdom. During almost five years of follow-up, 470 patients were diagnosedwith bladder cancer. Among patients who had taken Actos, theresearchers found an 83 percent increase in the relative risk forbladder cancer. But they said the absolute risk was low -- 89 cases among 100,000people who had taken the drug at any time during the five years offollow-up. In the general U.K. population, the rate of bladdercancer among those 65 and older is 73 cases per 100,000. The researchers also found that the risk increased as cumulativedosage increased. For those who had taken Actos for two years orlonger -- consuming 28,000 milligrams or more in total -- therelative risk of bladder cancer was increased 88 percent to 137cases per 100,000 patients. Weighing the risks and benefits, doctors who treat patientsdisagree about the continued use of Actos. Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital inNew York City, said "we need to be more careful with the use ofthis medication." The whole class of these drugs has come under fire, he said. "Ifthere are more studies like this, we will not be using thismedication," he added. Mezitis said he starts new type 2 diabetes patients on other drugssuch as metformin to control blood sugar, rather than Actos.Because it's a generic drug, metformin also is less expensive thanActos. Mezitis also thinks more patients with type 2 diabetes will getinsulin earlier instead of using drugs like Actos. "We have to tailor treatment to each patient, and there are otherways of controlling blood sugar," he said. Another expert, Dr. Joel Zonszein, a professor of clinical medicineat Albert Einstein College of Medicine and an endocrinologist atthe Clinical Diabetes Center at Montefiore Medical Center in NewYork City, said he thinks the study is weak, and the risk ofbladder cancer is small. "There is an important role for these medications," he said. "I amprobably one of the last doctors who is still supporting the use ofthese medications." Zonszein said he starts patients on Actos in combination with otherdrugs such as metformin to aggressively lower blood sugar.Patients, however, need to know the risks, he said. More information For more information on diabetes, visit the U.S. National Library of Medicine . SOURCES:Laurent Azoulay, Ph.D.,Center for ClinicalEpidemiology,Lady Davis Institute, Jewish General Hospital,andDepartment of Oncology,McGill University,Montreal;Spyros Mezitis,M.D., endocrinologist, Lenox Hill Hospital, New York City;JoelZonszein, M.D., professor of clinical medicine, Albert EinsteinCollege of Medicine,Clinical Diabetes Center, Montefiore MedicalCenter, New York City;May 31, 2012, BMJ , online Copyright © 2012 HealthDay . All rights reserved. We are high quality suppliers, our products such as China 3G Wifi GPS Mobile Phones , Wifi Mobiles Phones Manufacturer for oversee buyer. To know more, please visits 3G Wifi GPS Mobile Phones.
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