MedPage Today reports that thiazolidinediones (aka glitazones) are linked to development of bladder cancer. Pioglitazone is the most commonly used TZD in the U.S. From the article:
The increased risk of bladder cancer associated with glitazones — which reached a relative increase of 72% in patients who started on the agents more than 5 years earlier — “appears to be a class effect,” the research team, led by Ronac Mamtani, MD, of the University of Pennsylvania in Philadelphia, concluded.
According to the National Cancer Institute, the U.S. has 74,000 new cases of bladder cancer yearly, and 15,000 annual deaths from bladder cancer.
If you take a thiazolidinedione, talk to your doctor about bladder cancer at your next visit.
Steve Parker, M.D.
You do NOT want this hip bone to break!
A study presented at the 2009 Scientific Sessions of the American Diabetes Association associated thiazolidinedione drugs with a 40% higher fracture risk.
Thiazolidinediones used in the U.S. are rosiglitazone (Avandia) and pioglitazone (Actos). “Thiazolidinedione” is so hard to pronounce that my physician colleagues refer to them as “TZDs” or “glitazones.”
The researchers examined the Medco database – more than 13 million people – looking for people with diabetes between the ages of 43 and 63 at study onset who were using TZDs, metformin, exenatide (Byetta), or a sulfonylurea (e.g., glipizide, glyburide, glimiperide).
Note that this study has not yet undergone the peer-review process and been published in a medical journal.
These results are prelimary and require confirmation and peer-review by experts in the field. Nevertheless, if I had diabetes and were at risk of broken bones – presence of osteoporosis, for example – I would ask my doctor about alternatives before taking TZDs. Stay alert for developments.
Steve Parker, M.D.
Reference: Wood, Shelley. More evidence links glitazones to broken bones. TheHeart.org, June 12, 2009.