Pioglitazone and risk of bladder cancer among diabetic patients in France: a population-based cohort study.
Pioglitazone and risk of bladder cancer among diabetic patients in France: a population-based cohort study.
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DOI：
10.1007/s00125-012-2538-9
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发表时间：
2012-07
期刊：
影响因子：
8.2
通讯作者：
Allemand, H.
中科院分区：
文献类型：
--
作者：
Neumann, A.;Weill, A.;Ricordeau, P.;Fagot, J. P.;Alla, F.;Allemand, H.
关键词：
先前的研究表明吡格列酮暴露会增加膀胱癌的风险。我们的目的是调查吡格列酮暴露与法国膀胱癌之间的关系。本队列研究使用了法国国家医疗保险信息系统（Système National d 'Information Inter-régimes de l' Assurance Maladie; SNIIRAM）与法国出院数据库（Programme de Médicalisation des Systèmes d 'Information; PMSI）的数据。该队列包括年龄在40至79岁之间的患者，他们在2006年填写了降糖药物处方。该队列随访长达42个月。将吡格列酮暴露量建模为时间依赖性变量，并通过在6个月内填写至少2份处方进行定义。通过膀胱癌的出院诊断结合特定的积极治疗来确定膀胱癌的发病病例。统计学分析涉及多变量考克斯模型，校正了年龄、性别和其他降糖药物暴露。该队列包括1，491，060例糖尿病患者，其中155，535例暴露于吡格列酮。我们在暴露患者中发现了175例膀胱癌病例，在非暴露患者中发现了1，841例。发病率分别为49.4和42.8/10万人年。吡格列酮暴露与膀胱癌发生率显著相关（校正HR 1.22 [95% CI 1.05，1.43]）。我们观察到剂量-效应关系，高累积剂量（≥ 28，000 mg，校正HR 1.75 [95% CI 1.22，2.50]）和长暴露持续时间（≥24个月，校正HR 1.36 [1.04，1.79]）的风险显著增加。在来自法国的糖尿病患者队列中，吡格列酮暴露与膀胱癌风险增加显著相关。
Previous studies have suggested an increased risk of bladder cancer with pioglitazone exposure. We aimed to investigate the association between pioglitazone exposure and bladder cancer in France. This cohort study involved use of data from the French national health insurance information system (Système National d'Information Inter-régimes de l'Assurance Maladie; SNIIRAM) linked with the French hospital discharge database (Programme de Médicalisation des Systèmes d'Information; PMSI). The cohort included patients aged 40 to 79 years who filled a prescription for a glucose-lowering drug in 2006. The cohort was followed for up to 42 months. Pioglitazone exposure was modelled as a time-dependent variable and defined by having filled at least two prescriptions over a 6-month period. Incident cases of bladder cancer were identified by a discharge diagnosis of bladder cancer combined with specific aggressive treatment. Statistical analyses involved a multivariate Cox model adjusted for age, sex and exposure to other glucose-lowering drugs. The cohort included 1,491,060 diabetic patients, 155,535 of whom were exposed to pioglitazone. We found 175 cases of bladder cancer among exposed patients and 1,841 among non-exposed patients. Incidence rates were 49.4 and 42.8 per 100,000 person-years, respectively. Pioglitazone exposure was significantly associated with bladder cancer incidence (adjusted HR 1.22 [95% CI 1.05, 1.43]). We observed a dose–effect relationship, with a significantly increased risk for high cumulative doses (≥28,000 mg, adjusted HR 1.75 [95% CI 1.22, 2.50]) and long duration of exposure (≥24 months, adjusted HR 1.36 [1.04, 1.79]). In this cohort of diabetic patients from France, pioglitazone exposure was significantly associated with increased risk of bladder cancer.
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影响因子：
168.9
作者：
Dormandy, JA;Charbonnel, B;Taton, J
通讯作者：
Taton, J
影响因子：
0.9
作者：
Tuppin, P.;de Roquefeuil, L.;Merliere, Y.
通讯作者：
Merliere, Y.
影响因子：
6.4
作者：
Hemelt, Marjolein;Yamamoto, Hidekazu;Zeegers, Maurice P. A.
通讯作者：
Zeegers, Maurice P. A.
DOI：
10.1038/sj.neo.7900050
发表时间：
1999-10-01
期刊：
Neoplasia (New York)
影响因子：
--
作者：
Guan, You-Fei;Zhang, Ya-Hua;Breyer, Matthew D.
通讯作者：
Breyer, Matthew D.
影响因子：
1.5
作者：
Dominick, Mark A.;White, Melvin R.;Schilling, Beth E.
通讯作者：
Schilling, Beth E.