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Can Taking Metformin Cause Bladder Cancer?

Effect Of Metformin On Mortality Among Diabetic Cancer Patients: A Systematic Review And Meta-analysis | Jnci Cancer Spectrum | Oxford Academic

Effect Of Metformin On Mortality Among Diabetic Cancer Patients: A Systematic Review And Meta-analysis | Jnci Cancer Spectrum | Oxford Academic

Most data suggest that cancer patients with diabetes have worse outcomes, which may be reversed with metformin. Metformin might modulate the clinical outcomes of diabetic cancer patients. We performed a systematic review and meta-analysis based on published studies over the past five years to summarize the effects of metformin on diabetic cancer patients. We systematically searched for studies that were published over the past five years. Then, we evaluated these studies for inclusion and extracted the relevant data. The summary risk estimates for the association between metformin treatment and all-cause mortality (ACM) and cancer-specific mortality (CSM) were analyzed using random or fixed-effects models. Stratified analyses by cancer site and country were also conducted. Based on the 42 studies included in our analysis (37 015 diabetic cancer patients), we found a significant benefit associated with metformin treatment on survival corresponding to 27% and 26% reductions in ACM (hazard ratio [HR] = 0.73, 95% confidence interval [CI] = 0.68 to 0.79, P < .001) and CSM (HR = 0.74, 95% CI = 0.64 to 0.86, P < .001), respectively. The ACM rates for colorectal cancer, endometrial cancer, breast cancer, prostate cancer, and ovarian cancer showed significant benefits associated with metformin treatment in our stratified analyses by cancer site. Stratified analyses by cancer site also showed a significant reduction in CSM for breast cancer. This association between metformin treatment and reduced CSM for diabetic breast cancer patients was also observed in our country subgroup analyses. We found an association between metformin exposure and reduced ACM and CSM in diabetic patients with cancer. Our findings suggest that metformin treatment could be an effective treatment option Continue reading >>

Pioglitazone Bladder Cancer Link Seen Again

Pioglitazone Bladder Cancer Link Seen Again

Pioglitazone Bladder Cancer Link Seen Again But absolute risk remains low overall, finds large British study by Parker Brown Parker Brown, Staff Writer, MedPage Today This article is a collaboration between MedPage Today and: Note that this observational study of British patients with diabetes found that the use of pioglitazone, compared with other antidiabetic agents, was associated with an increased risk of bladder cancer. Be aware that the absolute risk of bladder cancer in the population was quite low. Pioglitazone (Actos) was associated with a higher risk of bladder cancer than other diabetes drugs in a large population-based cohort study. Researchers looked at about 146,000 patients in the U.K. who had recently started taking an anti-diabetic drug; those on pioglitazone faced an increased risk of bladder cancer of 121.0 versus 88.9 per 100,000 person-years among those on other diabetes drugs (hazard ratio 1.63, 95% CI 1.22-2.19). Fifty-four patients receiving pioglitazone were diagnosed with cancer after a mean follow-up of 4.7 years. But those on rosiglitazone (Avandia) didn't see an increased risk of bladder cancer (HR 1.10, 95% CI 0.83-1.47), according to lead author Marco Tuccori, PhD , at the Jewish General Hospital in Montreal, Canada, suggesting that the increased risk was not a class effect. Tuccori and colleagues published their findings on Wednesday in The BMJ . In 2015, Actos manufacturer Takeda agreed to pay $2.4 billion to settle lawsuits alleging that it hid bladder cancer risks associated with the drug from patients. The new study is the latest in a long-running seesaw drama, with one study identifying an increased bladder cancer risk with the drug, only to be followed by another showing no link. The latest results support findings from a 2005 tria Continue reading >>

Does Pioglitazone Increase The Risk Of Bladder Cancer?

Does Pioglitazone Increase The Risk Of Bladder Cancer?

Does pioglitazone increase the risk of bladder cancer? Pioglitazone is a medicine in the glitazone family which may slightly increase the risk of bladder cancer.This is still under investigation, but below is some information about the current concerns. Since 2000, several studies have been running to try to identify a possible link between pioglitazone and bladder cancer. Initial studies were inconclusive. However, there were more spontaneous reports than expected of people on pioglitazone being found to have bladder cancer. A European-wide review in July 2011 found a small increase in the risk of bladder cancer in people taking pioglitazone, especially after long-term use. Assessing people for risk of bladder cancer before starting treatment could help to reduce this small risk and allow people for whom pioglitazone is the best option in terms of their diabetes, to benefit from the drug. Symptoms such as needing to pass urine frequently or pain on passing urine without a clear cause (such as a urine infection) Occupational exposure to certain dyes (used in textiles and industry, probably not standard hair dyes) Certain infections such as schistosomiasis (uncommon in the UK). The advantages of pioglitazone in terms of glucose control may outweigh the risks in some cases. For those taking pioglitaone, tell your doctor if you notice any blood in your urine or any other symptom relating to your urine or bladder. Doctors should review risk of bladder cancer before starting treatment and review the treatment every three to six months. Other factors may also be important as pioglitazone may increase the risk of fractures and of developing pneumonia. More information on risk factors from Cancer Research UK. Recommendations from the European Medical Agency. Continue reading >>

New Insight For Metformin Against Bladder Cancer

New Insight For Metformin Against Bladder Cancer

New insight for metformin against bladder cancer 1Pharmacology and Toxicology Department, Faculty of Pharmacy, Al-Azhar University, Nasr City, Cairo, Egypt 2CAS-TWAS Fellowship at University of Science and Technology of China (USTC), Hefei, 23027 China 1Pharmacology and Toxicology Department, Faculty of Pharmacy, Al-Azhar University, Nasr City, Cairo, Egypt 2CAS-TWAS Fellowship at University of Science and Technology of China (USTC), Hefei, 23027 China Amr Ahmed EL-Arabey, Email: [email protected] , Email: [email protected]_lerma . Received 2016 Oct 30; Accepted 2017 Feb 3. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. International Agency for Research on Cancer (IARC) estimated that bladder cancer is the ninth most common cancer in the world, with 430,000 new cases and 165,000 deaths in 2012. Bladder cancer represents the fourth most common cancer in men and ninth most common cancer in women. It is the second most prevalent cancer in men 60years of age or older in United States. Looking further down, continuing advancements in cancer research could potentially offer more choices for clinician and patient with longer survival and better quality of life. Although, bladder cancer represents an ideal tumor model to test and apply cancer prevention strategies; there are limited studies about application of metformin in the man Continue reading >>

Actos

Actos

Actos (pioglitazone) is an oral Type 2 diabetes drug that lowers blood sugar by decreasing insulin resistance and reducing the amount of glucose made in the liver. This allows the body to better dispose of excess blood sugar. Typically, the dose starts at 15 or 30 mg and is taken once a day, but some people may require a stronger dose. Doctors can increase the strength of the medicine by 15 mg increments to a maximum of 45 mg daily. However, numerous studies and a review by the U.S. Food and Drug Administration (FDA) link higher dosages and prolonged use to an increased risk of bladder cancer and other serious conditions. Actos is not intended to treat Type 1 diabetes or diabetic ketoacidosis. The drug can be used alone or with other Type 2 diabetes medicines such as metformin. There are two additional types of Actos that combine pioglitazone and metformin: Actoplus Met and Actoplus Met XR (extended release). What Does Actos Treat? Actos is approved to treat Type 2 diabetes in adults by improving glycemic (defined as causing glucose – sugar – in the blood) control. The drug comes in a tablet form to be taken by mouth daily and should be used in combination with diet and exercise. People with Type 2 diabetes do not make or use insulin well. Insulin is a hormone produced by the pancreas that regulates the amount of glucose in the blood. It moves blood sugar into cells where it is stored for later use as energy. Type 2 diabetes results in higher than normal levels of glucose because glucose does not enter cells. The body is then unable to use the glucose for energy. Type 2 diabetes is a lifelong (chronic) disease that can develop at any age, including during childhood. However, it mostly occurs in middle-aged and older people. The condition often develops slowly over t Continue reading >>

Metformin Fails To Reduce Bladder Cancer Risk, Safer Than Actos: Study

Metformin Fails To Reduce Bladder Cancer Risk, Safer Than Actos: Study

Metformin Fails To Reduce Bladder Cancer Risk, Safer Than Actos: Study Researchers were disappointed to find that the drug metformin did not reduce the risk of bladder cancer among individuals with type 2 diabetes, but they did find that it does not increase the bladder cancer risk, like several studies have suggested side effects of Actos does. In a study published this month in the medical journal Diabetes Care , researchers from the University of Pennsylvanias Abramson Cancer Center found that patients taking metformin or drugs from a class known as sulfonylureas, like Dymelor and Orinase, did not see a reduction in the rate of bladder cancer. Bladder cancer is a potential risk that may be associated with diabetes, and researchers hoped that the diabetes drug metformin may have a prophylactic effect. However, after looking at data involving 87,000 patients with diabetes in The Health Improvement Network, researchers indicate that they found no statistical difference in the bladder cancer rates among those who took the drugs and those who did not. Researchers did recommend scientists take a look at metformin in comparison to other cancer rates as well, as bladder cancer is only one type of cancer some believed metformin may help prevent. Use of metformin is not associated with a decreased incidence of bladder cancer, the researchers concluded. Similar methods should be used to study other cancers that have previously been identified as potentially preventable with metformin. The study comes amid continuing concerns about the link between bladder cancer and Actos , a competing diabetes drug. While all diabetes patients may face a slight increase in the risk of bladder cancer, several studies have suggested that long-term Actus users face a substantially increased risk Continue reading >>

Effectiveness Of Metformin In Protection Against Bladder Cancer

Effectiveness Of Metformin In Protection Against Bladder Cancer

Home / Specialties / Oncology / Effectiveness of Metformin in Protection against Bladder Cancer Effectiveness of Metformin in Protection against Bladder Cancer Researchers looked at whether exposure to metformin is associated with a decreased risk of bladder cancer. Metformin works to decrease blood glucose by activating AMP-activated protein kinase (AMPK), which occurs through the reduction of mammalian target of rapamycin (mTOR) signaling. This mechanism is also known to inhibit cancer cell growth and proliferation, meaning metformin may have an additional benefit of reducing cancer risk. Bladder cancer is known to require activation of the mTOR pathway, making metformin ideal for this type of cancer. Previous observational studies have found metformin to be associated with a decreased risk of other cancers, including cancers of the breast, colon, liver, lung, pancreas, and prostate, though certain biases may have resulted in an exaggeration of these associations. As bladder cancer occurs more commonly in patients with T2DM and there is limited data regarding the relationship between metformin and bladder cancer, a study by Mamtani, R. et al. was developed to examine the risk of bladder cancer in new users of metformin and sulfonylureas among a cohort of patients with T2DM not previously using these medications. This study was conducted using data from The Health Improvement Network (THIN), an electronic medical records database used in the UK. The database contains information for >10 million patients, making it ideal for rarer outcomes such as bladder cancer. This retrospective cohort study looked at patients that began using either metformin or a sulfonylurea between July 1, 2000 and August 31, 2010. Sulfonylureas were chosen as the comparator drugs in this study Continue reading >>

Metformin (glucophage) Side Effects & Complications

Metformin (glucophage) Side Effects & Complications

The fascinating compound called metformin was discovered nearly a century ago. Scientists realized that it could lower blood sugar in an animal model (rabbits) as early as 1929, but it wasn’t until the late 1950s that a French researcher came up with the name Glucophage (roughly translated as glucose eater). The FDA gave metformin (Glucophage) the green light for the treatment of type 2 diabetes in 1994, 36 years after it had been approved for this use in Britain. Uses of Generic Metformin: Glucophage lost its patent protection in the U.S. in 2002 and now most prescriptions are filled with generic metformin. This drug is recognized as a first line treatment to control blood sugar by improving the cells’ response to insulin and reducing the amount of sugar that the liver makes. Unlike some other oral diabetes drugs, it doesn’t lead to weight gain and may even help people get their weight under control. Starting early in 2000, sales of metformin (Glucophage) were challenged by a new class of diabetes drugs. First Avandia and then Actos challenged metformin for leadership in diabetes treatment. Avandia later lost its luster because it was linked to heart attacks and strokes. Sales of this drug are now miniscule because of tight FDA regulations. Actos is coming under increasing scrutiny as well. The drug has been banned in France and Germany because of a link to bladder cancer. The FDA has also required Actos to carry its strictest black box warning about an increased risk of congestive heart failure brought on by the drug. Newer diabetes drugs like liraglutide (Victoza), saxagliptin (Onglyza) and sitagliptin (Januvia) have become very successful. But metformin remains a mainstay of diabetes treatment. It is prescribed on its own or sometimes combined with the newer d Continue reading >>

Pioglitazone And Metformin (oral Route)

Pioglitazone And Metformin (oral Route)

Precautions Drug information provided by: Micromedex It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects. Check with your doctor right away if you start having chest pain; shortness of breath; excessive swelling of the hands, wrist, ankles, or feet; or if you are rapidly gaining weight. These may be symptoms of a serious heart problem. Let your doctor or dentist know you are taking this medicine. Your doctor may advise you to stop taking this medicine before you have major surgery or diagnostic tests, especially tests that use a contrast dye. Under certain conditions, too much metformin can cause a serious condition called lactic acidosis. The symptoms of lactic acidosis are severe and appear quickly. Lactic acidosis usually occurs when other serious health problems are present, such as a heart attack or kidney failure. The symptoms of lactic acidosis include: abdominal or stomach discomfort; decreased appetite; diarrhea; fast or shallow breathing; a general feeling of discomfort; muscle pain or cramping; and unusual sleepiness, tiredness, or weakness. If you have more than one of these symptoms together, you should get immediate emergency medical help. Tell your doctor right away if you have any of these symptoms: loss of appetite, nausea, vomiting, stomach pain, unusual tiredness or weakness, weight loss, or yellow eyes or skin. These may be symptoms of a serious liver problem. Check with your doctor right away if blurred vision, decreased vision, or any other change in vision occurs while you are taking this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor). Certain women may be at Continue reading >>

No Bladder-cancer Protection With Metformin, New Study Finds

No Bladder-cancer Protection With Metformin, New Study Finds

No Bladder-Cancer Protection With Metformin, New Study Finds The most commonly used medication for type 2 diabetes, metformin, may not offer protection from bladder cancer, the findings of a new cohort study suggest. Previous observational studies have linked metformin use with a reduction in cancer of the breast, colon , liver, lung , and pancreas , and 2 recent meta-analyses have shown an overall 30% reduction in all cancers with metformin compared with other diabetes medications. However, few data are available for bladder cancer, say Ronac Mamtani, MD, attending physician, hematology-oncology, Philadelphia Veterans Affairs Medical Center, Pennsylvania, and colleagues in their article, published online February 4 in Diabetes Care. Bladder cancer in particular is important both because people with type 2 diabetes have about a 40% increased risk of developing it and because another diabetes drug, the thiazolidinedione pioglitazone, has been linked with a possible increased risk . Use of metformin was not associated with a significantly decreased risk for bladder cancer at a median follow-up of about 2 years in the new study (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.60 1.09), say the authors. "In the UK's Health Improvement Network (THIN) patient population, we found no evidence for a decreased risk of bladder cancer in type 2 diabetes patients using metformin," they write. But Peter T. Donnan, PhD, professor of epidemiology and biostatistics, population health sciences, University of Dundee, and codirector of Tayside Clinical Trials Unit, Scotland, disagrees. "The findings indicate a 19% reduction in hazard for bladder cancer associated with use of metformin. The value of the HR is not inconsistent with previous findings in individual studies as well a Continue reading >>

Metformin May Have A Protective Effect In Bladder Cancer Patients

Metformin May Have A Protective Effect In Bladder Cancer Patients

Metformin May Have a Protective Effect in Bladder Cancer Patients Metformin May Have a Protective Effect in Bladder Cancer Patients Diabetics taking the drug had a significant 68% decreased risk of grade progression compared with diabetics not on the drug. Metformin use may decrease the risk of grade progression in patients with non-muscle invasive bladder cancer (NMIBC), according to study findings presented at the Canadian Urological Association 2016 annual meeting in Vancouver. Samer L. Traboulsi, MD, and colleagues at McGill University Health Centre in Montreal conducted a retrospective analysis of 1,356 NMIBC patients with a median age of 69.5 years. The cohort consisted of 1,197 patients (88.3%) without diabetes, 93 patients (6.9%) with diabetes on metformin, and 66 patients (4.9%) with diabetes and not on metformin who served as a reference group. In multivariate analysis, metformin use was not associated with disease recurrence and stage and disease progression, but it was associated with a significant 68% decreased risk of grade progression compared with the reference group. In addition, patients without diabetes had a significant 42% lower risk for disease progression compared with the reference group. Metformin is hypothesized to have antineoplastic activity due to its inhibitor activity on mammalian target of rapamycin, the researchers explained in a poster presentation. Investigations in clinical trials are needed to show whether metformin mitigates the deleterious effect of diabetes on stage progression, Dr. Traboulsi's group concluded. Previously, in a paper published in Urologic Oncology (2015;33:386.e7-386.e13), Canadian researchers reported on a study of 421 patients undergoing radical cystectomy for bladder cancer showing that metformin users had a 6 Continue reading >>

Does Metformin Cause Cancer In Bladder?

Does Metformin Cause Cancer In Bladder?

Home Q & A Questions Does metformin cause cancer... while it may not be a known side effect, my mother in law took it and we just buried her from bladder cancer. My dad never smoked but he did take metformin for years (still is) and was just diagnosed with bladder cancer a couple months ago. Whether bladder cancer is a "Listed" side effect or not is not the issue. The issue is that many people are getting bladder cancer from the use of Metformin. I used Metformin for a few years for diabetes and fortunately discovered stage 1 bladder cancer accidentally when passing a kidney stone in April of 2012. The use of Metformin and the link to bladder cancer NEEDS to be investigated. we just buried my mother, she suffered from Transitional Cell Carcinoma of the bladder and kidneys, does metformin cause this type of cancer??? She was on it for years for type 2 diabetes I was diagnosed about 4 years ago with Bladder cancer and have had about 3 operations since then. Still have my bladder but I am still being treated for it. I took Metformin for several years and am wondering just how many people like me ended up with bladder cancer. Continue reading >>

Metformin: Can A Diabetes Drug Help Prevent Cancer?

Metformin: Can A Diabetes Drug Help Prevent Cancer?

In 1957, the first results from a clinical trial of the diabetes drug metformin in patients were published. Yet, it would take nearly 40 years for the drug to be approved in the United States as a treatment for type 2 diabetes. Now researchers want to know whether this decades-old drug may have additional uses in another disease—cancer. Based on findings from a number of large epidemiologic studies and extensive laboratory research, metformin is being tested in clinical trials not only as a treatment for cancer, but as a way to prevent it in people at increased risk, including cancer survivors who have a higher risk of a second primary cancer. Numerous early-stage clinical trials are currently under way to investigate metformin’s potential to prevent an array of cancers, including colorectal, prostate, endometrial, and breast cancer. Several of these trials are being funded by NCI’s Consortia for Early Phase Prevention Trials. And NCI is collaborating with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to study participants from the landmark clinical trial, the Diabetes Prevention Program (DPP), to investigate metformin’s impact on cancer incidence. Some of the early-phase prevention trials of metformin are enrolling participants who are at increased risk for cancer and who are obese, have elevated glucose or insulin levels, or have other conditions that put them at risk for diabetes. “With the obesity epidemic, these studies are applicable to a substantial portion of the U.S. population and, increasingly, of the world population,” said Brandy Heckman-Stoddard, PhD, MPH, of NCI’s Division of Cancer Prevention. Expanding the Data Pool Much of the human data on metformin and cancer has come from epidemiologic studies of people w Continue reading >>

Bladder Cancer Link Seen Again With A Diabetes Drug

Bladder Cancer Link Seen Again With A Diabetes Drug

Home / Conditions / Type 2 Diabetes / Bladder Cancer Link Seen Again With A Diabetes Drug Bladder Cancer Link Seen Again With A Diabetes Drug While the risk remains low overall, a new large study showed a greater risk for pioglitazone than other diabetes drugs. Researchers looked at about 146,000 patients in the U.K. who had recently started taking an anti-diabetic drug; those on pioglitazone faced an increased risk of bladder cancer of 121.0 versus 88.9 per 100,000 person-years among those on other diabetes drugs (hazard ratio 1.63, 95% CI 1.22-2.19). Fifty-four patients receiving pioglitazone were diagnosed with cancer after a mean follow-up of 4.7 years. According to lead author Marco Tuccori, PhD, at the Jewish General Hospital in Montreal, Canada, the increased risk was not a class effect. But those on rosiglitazone (Avandia) didnt see an increased risk of bladder cancer (HR 1.10, 95% CI 0.83-1.47). Last year, Actos manufacturer Takeda agreed to pay $2.4 billion to settle lawsuits alleging that it hid from patients bladder cancer risks associated with the drug. Pioglitazone, an antidiabetic drug belonging to the thiazolidinedione class, has been shown to improve glycemic levels in people with type 2 diabetes. However, in 2005, the PROactive randomized controlled trial unexpectedly showed an imbalance in the number of cases of bladder cancer with pioglitazone compared with placebo. In contrast, this imbalance was never observed in randomized controlled trials of rosiglitazone, the other approved drug belonging to the thiazolidinedione class. The findings of the PROactive trial were subsequently corroborated in some, but not all, observational studies. Indeed, in the five-year interim analysis of a large observational study using the Kaiser Permanente Northern Calif Continue reading >>

Metformin And Gefitinib Cooperate To Inhibit Bladder Cancer Growth Via Both Ampk And Egfr Pathways Joining At Akt And Erk

Metformin And Gefitinib Cooperate To Inhibit Bladder Cancer Growth Via Both Ampk And Egfr Pathways Joining At Akt And Erk

Article | Open Metformin and gefitinib cooperate to inhibit bladder cancer growth via both AMPK and EGFR pathways joining at Akt and Erk Scientific Reports volume 6, Articlenumber:28611 (2016) EGFR is a potential therapeutic target for treating bladder cancer, but has not been approved for clinical use yet. Metformin is a widely used antidiabetic drug and has demonstrated interesting anticancer effects on various cancer models, alone or in combination with chemotherapeutic drugs. The efficacy of gefitinib, a well-known EGFR tyrosine kinase inhibitor, combined with metformin was assessed on bladder cancer and underlying mechanisms were explored. This drug combination induced a strong anti-proliferative and anti-colony forming effect and apoptosis in bladder cancer cell lines. Gefitinib suppressed EGFR signaling and inhibited phosphorylation of ERK and Akt. Metformin amplified this inhibitory effect and enhanced gefitinib-induced activation of AMPK signaling pathway. In vivo intravesical treatment of metformin and gefitinib on syngeneic orthotopic mice confirmed the significant inhibitory effect on bladder tumor growth. These two drugs may be an excellent combination for the treatment of bladder cancer through intravesical instillation. Bladder cancer is one of the most common cancers of the urinary tract in the world, accounting for about 74,000 new cases and 16,000 deaths in the United State in 2015 1 . Although radical cystectomy with chemotherapy has been applied for treating bladder cancer patients as the standard clinical administration and exerted efficient benefits, recurrence and metastasis take place frequently 2 . To prevent recurrence and progression, intravesical chemotherapy or immunosuppressive agents have been widely used after radical cystectomy 3 , 4 . Continue reading >>

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