At that point, the 376 patients w/bladder cancer diagnosed after a year into their new drug use were than matched to 6,699 controls. And presto! Any use of pioglitazone was associated w/83% increased risk of bladder cancer. And the longer the duration of use (especially after 24 months) and the higher the cumulative dosage (>28,000mg), the greater the risk.
While Avandia (rosiglitazone) is no longer easily available (only by restricted distribution) on the US Market, it's telling that the analysis found no link between use of this thiazolidinedione (TZD) and bladder cancer. So rather than a class effect, we're looking at a drug-specific effect. Likewise, the tables are turned when looking at rosiglitazone vs heart disease (positive association) as opposed to pioglitazone (no association), again suggesting drug effect, rather than class effect.
With this in mind, perhaps we should start reconsidering our use of pioglitazone. Surely there must be safer therapeutic options for our diabetic patients? And while all medications & supplements have the potential both to heal & to harm (double-edged sword effect), as the editorialists noted , the tide of evidence appears to be turning against pioglitazone. Let's not be caught on the wrong side.