Dataset Information

Pioglitazone use and risk of bladder cancer: a systematic literature review and meta-analysis of observational studies.

ABSTRACT:

Background

Studies investigating bladder cancer risk in pioglitazone-treated type 2 diabetes mellitus patients report conflicting results. Previous meta-analyses on this topic utilized publications prior to 2013. More long-term observational studies have been published since then. We reviewed the accumulated evidence and updated findings from previous meta-analyses.

Methods

This meta-analysis was based on a systematic review of peer-reviewed observational studies published prior to September 30, 2016. Eligible studies were identified using a specified MEDLINE search. References from included studies and from previous meta-analyses were screened for additional records. Meta-analysis hazards ratios were derived using a random-effects model. Several sensitivity analyses including hierarchical Bayesian meta-analysis with country-specific effects were conducted.

Results

Of 363 identified records, 23 studies were included in this review and 18 in the actual meta-analyses. For bladder cancer outcome, the estimated effect size for ever vs. never use of pioglitazone was 1.16 [95% confidence interval (CI), 1.04-1.28]. In the cumulative dose and duration analyses, highest effect was observed in the highest/longest exposure group, but substantial heterogeneity was present. In the sensitivity analysis, only studies adjusted for lifestyle-related factors were included and the frequentist effect size was 1.18 (95% CI, 1.00-1.40, p?=?0.054). However, the risk was not verified in the Bayesian framework with an effect size of 1.17 [95% credible interval (CrI), 0.94-1.54].

Conclusions

In line with previous meta-analyses, we observed a small but statistically significant association between ever (vs. never) use of pioglitazone and bladder cancer risk; however, causality is not established and alternative explanations cannot be ruled out.

SUBMITTER: Mehtala J

PROVIDER: S-EPMC6357234 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Pioglitazone use and risk of bladder cancer: a systematic literature review and meta-analysis of observational studies.

Mehtälä Juha J Khanfir Houssem H Bennett Dimitri D Ye Yizhou Y Korhonen Pasi P Hoti Fabian F

Diabetology international 20180614 1

<h4>Background</h4>Studies investigating bladder cancer risk in pioglitazone-treated type 2 diabetes mellitus patients report conflicting results. Previous meta-analyses on this topic utilized publications prior to 2013. More long-term observational studies have been published since then. We reviewed the accumulated evidence and updated findings from previous meta-analyses.<h4>Methods</h4>This meta-analysis was based on a systematic review of peer-reviewed observational studies published prior t ...[more]

PMID: 30800561

Similar Datasets

Project description:Some studies have reported that milk and dairy product consumption reduces bladder cancer incidence, whereas others have reported null or opposite findings. This meta-analysis of 26 cohort and case-control studies has been conducted to pool the risk of the association between milk and dairy products and bladder cancer. A systematic search in MEDLINE, EMBASE, and the Web of Science (from inception to 30 April 2018) was conducted. Random-effects models were used to compute pooled estimates of RR for high or medium compared with low consumption of milk and dairy. Sensitivity analyses were conducted. Subgroup analyses were performed based on type of dairy, gender, geographic location, and type of study design. Random-effects meta-regression was used to evaluate other confounding factors. Overall, medium compared with low consumption was associated with lower pooled risk of bladder cancer for total dairy products (RR = 0.90; 95% CI: 0.81, 0.98), milk (RR = 0.90; 95% CI: 0.82, 0.98), and fermented dairy products (RR = 0.87; 95% CI: 0.79, 0.96). The inverse association for milk consumption was stronger in Asians (RR = 0.79; 95% CI: 0.59, 0.98) and in cohort design studies (RR = 0.85; 95% CI: 0.71, 0.99). Moreover, high compared with low consumption was significantly associated with a lower pooled risk for milk (RR = 0.89; 95% CI: 0.81, 0.98) and fermented dairy products (RR = 0.78; 95% CI: 0.61, 0.94). However, high compared with low consumption of whole milk was significantly associated with a higher risk (RR = 1.21; 95% CI: 1.04, 1.38). The statistical heterogeneity was considerable. In conclusion, the present meta-analysis suggests a decreased risk of bladder cancer associated with medium consumption of total dairy products and with medium and high consumption of milk and fermented dairy products. An increased risk of bladder cancer was observed with high consumption of whole milk. Interpretations of the results should be made with caution. This review was registered at www.crd.york.ac.uk/prospero as CRD42018097020.

Project description:ObjectivesThe aetiology of gastroschisis is considered multifactorial. We conducted a systematic review and meta-analysis to assess whether the use of medications during pregnancy, is associated with the risk of gastroschisis in offspring.MethodsPubMed, EMBASE, and Scopus were searched from 1st January 1990 to 31st December 2020 to identify observational studies examining the association between medication use during pregnancy and the risk of gastroschisis. The Newcastle-Ottawa Scale was used for the quality assessment of the individual studies. We pooled adjusted measures using a random-effect model to estimate relative risk [RR] and the 95% confidence interval [CI]. I2 statistic for heterogeneity and publication bias was calculated.ResultsEighteen studies providing data on 751,954 pregnancies were included in the meta-analysis. Pooled RRs showed significant associations between aspirin (RR 1.66, 95% CI 1.16-2.38; I2 = 58.3%), oral contraceptives (RR 1.52, 95% CI 1.21-1.92; I2 = 22.0%), pseudoephedrine and phenylpropanolamine (RR 1.51, 95% CI 1.16-1.97; I2 = 33.2%), ibuprofen (RR 1.42, 95% CI 1.26-1.60; I2 = 0.0%), and gastroschisis. No association was observed between paracetamol and gastroschisis (RR 1.16, 95% CI 0.96-1.41; I2 = 39.4%).ConclusionsThese results suggest that the exposure in the first trimester of pregnancy to over the counter medications (OTC) such as aspirin, ibuprofen, pseudoephedrine and phenylpropanolamine as well as to oral contraceptives, was associated with an increased risk of gastroschisis. However, these associations are significant only in particular subgroups defined by geographic location, adjustment variables and type of control. Therefore, further research is needed to investigate them as potential risk factors for gastroschisis, to assess their safety in pregnancy and to develop treatment strategies to reduce the risk of gastroschisis in offspring. PROSPERO registration number: CRD42021287529.

Dataset Information

Pioglitazone use and risk of bladder cancer: a systematic literature review and meta-analysis of observational studies.

Background

Methods

Results

Conclusions

Publications

Pioglitazone use and risk of bladder cancer: a systematic literature review and meta-analysis of observational studies.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets