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In several studies, the diabetes drug pioglitazone (Actos) has been associated with risk for bladder cancer (JW Gen Med Jun 21 2012). In this retrospective study, researchers used a U.K. database to compare the incidence of bladder cancer in 18,000 users of thiazolidinedione (TZD) drugs (i.e., pioglitazone and rosiglitazone [Avandia]) and 41,000 users of sulfonylureas. Although median follow-up was about 3 years, follow-up exceeded 5 years in 25% of patients.
Overall, 197 bladder cancers were diagnosed (about 1 case per 300 patients). After adjustment for potential confounders, risk for bladder cancer was significantly higher after ≥5 years of TZD use (hazard ratio, 3.42 for 5-year users compared with risk in <1-year users). Moreover, ≥5 yea…