Abstract

Antidiabetic medications are commonly used around the world, but their safety is still unclear. The aim of this study was to investigate whether long-term use of insulin and oral antidiabetic medications is associated with cancer risk.We conducted a well-designed case-control study using 12 years of data from Taiwan's National Health Insurance Research Database and investigated the association between antidiabetic medication use and cancer risk over 20 years. We identified 42,500 patients diagnosed with cancer and calculated each patient's exposure to antidiabetic drugs during the study period. We matched cancer and noncancer subjects matched 1:6 by age, gender, and index date, and used Cox proportional hazard regression and conditional logistic regression, adjusted for potential confounding factors, that is, medications and comorbid diseases that could influence cancer risk during study period.Pioglitazone (adjusted odds ratio [AOR], 1.20; 95% confidence interval [CI], 1.05-1.38); and insulin and its analogs for injection, intermediate or long acting combined with fast acting (AOR, 1.22; 95% CI, 1.05-1.43) were significantly associated with a higher cancer risk. However, metformin (AOR, 1.00; 95% CI, 0.93-1.07), glibenclamide (AOR, 0.98; 95% CI, 0.92-1.05), acarbose (AOR, 1.06; 95% CI, 0.96-1.16), and others do not show evidence of association with cancer risk. Moreover, the risk for specific cancers among antidiabetic users as compared with nonantidiabetic medication users was significantly increased for pancreas cancer (by 45%), liver cancer (by 32%), and lung cancer (by 18%).Antidiabetic drugs do not seem to be associated with an increased cancer risk incidence except for pioglitazone, insulin and its analogs for injection, intermediate or long acting combined with fast acting.

Original languageEnglish
Article numbere17461
Pages (from-to)e17461
JournalMedicine (United States)
Volume98
Issue number40
DOIs
Publication statusPublished - Oct 1 2019

Fingerprint

Hypoglycemic Agents
pioglitazone
Neoplasms
Odds Ratio
Confidence Intervals
Insulin
Liver Neoplasms
Lung Neoplasms
Acarbose
Injections
Glyburide
Metformin
National Health Programs
Pancreatic Neoplasms
Taiwan
Case-Control Studies
Logistic Models
Databases
Safety
Incidence

Keywords

  • antidiabetics
  • cancer
  • carcinogenicity
  • drug toxicity
  • long-term drug exposure
  • medicine
  • observational health data
  • pharmacoepidemiology
  • safe drugs
  • Humans
  • Middle Aged
  • Male
  • Hypoglycemic Agents/administration & dosage
  • Case-Control Studies
  • Incidence
  • Dose-Response Relationship, Drug
  • Female
  • Odds Ratio
  • Neoplasms/epidemiology
  • Drug Administration Schedule
  • Risk Factors
  • Proportional Hazards Models
  • Logistic Models
  • Taiwan
  • Aged

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Does long-term use of antidiabetic drugs changes cancer risk? / Liu, Yi Chun; Nguyen, Phung Anh; Humayun, Ayesha; Chien, Shuo Chen; Yang, Hsuan Chia; Asdary, Rahma Novita; Syed-Abdul, Shabbir; Hsu, Min Huei; Moldovan, Max; Yen, Yun; Li, Yu Chuan; Jian, Wen Shan; Iqbal, Usman.

In: Medicine (United States), Vol. 98, No. 40, e17461, 01.10.2019, p. e17461.

Research output: Contribution to journalArticle

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abstract = "Antidiabetic medications are commonly used around the world, but their safety is still unclear. The aim of this study was to investigate whether long-term use of insulin and oral antidiabetic medications is associated with cancer risk.We conducted a well-designed case-control study using 12 years of data from Taiwan's National Health Insurance Research Database and investigated the association between antidiabetic medication use and cancer risk over 20 years. We identified 42,500 patients diagnosed with cancer and calculated each patient's exposure to antidiabetic drugs during the study period. We matched cancer and noncancer subjects matched 1:6 by age, gender, and index date, and used Cox proportional hazard regression and conditional logistic regression, adjusted for potential confounding factors, that is, medications and comorbid diseases that could influence cancer risk during study period.Pioglitazone (adjusted odds ratio [AOR], 1.20; 95{\%} confidence interval [CI], 1.05-1.38); and insulin and its analogs for injection, intermediate or long acting combined with fast acting (AOR, 1.22; 95{\%} CI, 1.05-1.43) were significantly associated with a higher cancer risk. However, metformin (AOR, 1.00; 95{\%} CI, 0.93-1.07), glibenclamide (AOR, 0.98; 95{\%} CI, 0.92-1.05), acarbose (AOR, 1.06; 95{\%} CI, 0.96-1.16), and others do not show evidence of association with cancer risk. Moreover, the risk for specific cancers among antidiabetic users as compared with nonantidiabetic medication users was significantly increased for pancreas cancer (by 45{\%}), liver cancer (by 32{\%}), and lung cancer (by 18{\%}).Antidiabetic drugs do not seem to be associated with an increased cancer risk incidence except for pioglitazone, insulin and its analogs for injection, intermediate or long acting combined with fast acting.",
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AU - Nguyen, Phung Anh

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AU - Yang, Hsuan Chia

AU - Asdary, Rahma Novita

AU - Syed-Abdul, Shabbir

AU - Hsu, Min Huei

AU - Moldovan, Max

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AU - Jian, Wen Shan

AU - Iqbal, Usman

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N2 - Antidiabetic medications are commonly used around the world, but their safety is still unclear. The aim of this study was to investigate whether long-term use of insulin and oral antidiabetic medications is associated with cancer risk.We conducted a well-designed case-control study using 12 years of data from Taiwan's National Health Insurance Research Database and investigated the association between antidiabetic medication use and cancer risk over 20 years. We identified 42,500 patients diagnosed with cancer and calculated each patient's exposure to antidiabetic drugs during the study period. We matched cancer and noncancer subjects matched 1:6 by age, gender, and index date, and used Cox proportional hazard regression and conditional logistic regression, adjusted for potential confounding factors, that is, medications and comorbid diseases that could influence cancer risk during study period.Pioglitazone (adjusted odds ratio [AOR], 1.20; 95% confidence interval [CI], 1.05-1.38); and insulin and its analogs for injection, intermediate or long acting combined with fast acting (AOR, 1.22; 95% CI, 1.05-1.43) were significantly associated with a higher cancer risk. However, metformin (AOR, 1.00; 95% CI, 0.93-1.07), glibenclamide (AOR, 0.98; 95% CI, 0.92-1.05), acarbose (AOR, 1.06; 95% CI, 0.96-1.16), and others do not show evidence of association with cancer risk. Moreover, the risk for specific cancers among antidiabetic users as compared with nonantidiabetic medication users was significantly increased for pancreas cancer (by 45%), liver cancer (by 32%), and lung cancer (by 18%).Antidiabetic drugs do not seem to be associated with an increased cancer risk incidence except for pioglitazone, insulin and its analogs for injection, intermediate or long acting combined with fast acting.

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KW - safe drugs

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KW - Middle Aged

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KW - Odds Ratio

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KW - Drug Administration Schedule

KW - Risk Factors

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KW - Aged

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