Cohort study of pioglitazone and cancer incidence in patients with diabetes.
Cohort study of pioglitazone and cancer incidence in patients with diabetes.
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DOI：
10.2337/dc10-1067
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发表时间：
2011-04
期刊：
影响因子：
16.2
通讯作者：
Habel LA
中科院分区：
文献类型：
--
作者：
Ferrara A;Lewis JD;Quesenberry CP Jr;Peng T;Strom BL;Van Den Eeden SK;Ehrlich SF;Habel LA
探索吡格列酮治疗是否与10个最常见部位（前列腺、女性乳腺、肺/支气管、子宫内膜、结肠、非霍奇金淋巴瘤[NHL]、胰腺、肾/肾盂、直肠和黑色素瘤）的癌症风险相关。对来自Kaiser Permanente北方加州糖尿病登记中心的252，467例年龄≥40岁的患者进行了一项队列研究。所有糖尿病药物处方均通过药房记录进行识别。采用考克斯比例风险模型检查癌症发病风险与既往使用、持续时间、剂量和自开始吡格列酮治疗以来的时间之间的相关性（建模为时间依赖性变量）。在校正年龄、性别、入组年份、人种/种族、收入、吸烟、血糖控制、糖尿病病程、肌酐水平、充血性心力衰竭和其他糖尿病药物使用的模型中，与既往使用吡格列酮相关的每种癌症的风险比（HR）范围为0. 7 - 1. 3，所有95% CI包括1. 0。提示与既往使用吡格列酮相关的黑色素瘤（HR 1.3 [95% CI 0.9-2.0]）和NHL（1.3 [1.0-1.8]）风险增加以及肾癌/肾盂癌风险降低（0.7 [0.4-1.1]）。这些相关性不随剂量、持续时间或首次使用后时间的增加而改变。我们没有发现明确的证据表明吡格列酮的使用与癌症发病风险之间存在关联。由于开始吡格列酮治疗后的最长随访时间不到6年，因此需要进行更长期的研究。
To explore whether treatment with pioglitazone was associated with risk of incident cancer at the 10 most common sites (prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma [NHL], pancreas, kidney/renal pelvis, rectal, and melanoma). A cohort study of 252,467 patients aged ≥40 years from the Kaiser Permanente Northern California Diabetes Registry was conducted. All prescriptions for diabetes medications were identified by pharmacy records. Cox proportional hazards models were used to examine the association between risk of incident cancer and ever use, duration, dose, and time since initiation of pioglitazone (modeled as time-dependent variables). In models adjusted for age, sex, year of cohort entry, race/ethnicity, income, smoking, glycemic control, diabetes duration, creatinine levels, congestive heart failure, and use of other diabetes medications, the hazard ratio (HR) for each cancer associated with ever use of pioglitazone ranged from 0.7 to 1.3, with all 95% CIs including 1.0. There was a suggestion of an increased risk of melanoma (HR 1.3 [95% CI 0.9–2.0]) and NHL (1.3 [1.0–1.8]) and a decreased risk of kidney/renal pelvis cancers (0.7 [0.4–1.1]) associated with ever use of pioglitazone. These associations were unaltered with increasing dose, duration, or time since first use. We found no clear evidence of an association between use of pioglitazone and risk of the incident cancers examined. Because the maximum duration of follow-up was fewer than 6 years after the initiation of pioglitazone, longer-term studies are needed.
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DOI：
10.1073/pnas.95.15.8806
发表时间：
1998-07-21
影响因子：
11.1
作者：
Elstner, E;Müller, C;Koeffler, HP
通讯作者：
Koeffler, HP
影响因子：
168.9
作者：
Dormandy, JA;Charbonnel, B;Taton, J
通讯作者：
Taton, J
影响因子：
3.8
作者：
Liu, H;Zang, C;Elstner, E
通讯作者：
Elstner, E
影响因子：
9.3
作者：
Ramos-Nino ME;MacLean CD;Littenberg B
通讯作者：
Littenberg B
影响因子：
45.3
作者：
Govindarajan, Rangaswamy;Ratnasinghe, Luke;Lang, Nicholas P.
通讯作者：
Lang, Nicholas P.