[Association of glitazones and bladder cancer: a rapid review].

Abstract

Background: Since the authorization of glitazones as oral antidiabetics, there has been a controversial debate as to whether they increase the risk of bladder cancer or accelerate its progression. Recent data have shown that glitazones can upregulate the expression of Nectin4.

Objectives: These results make a renewed detailed examination of the topic unavoidable. Consequently, we conducted a rapid evidence analysis. The primarily aim was to identify systematic reviews investigating this relationship. Second, translational studies that describe the molecular biological background were identified.

Materials and methods: A rapid evidence analysis was conducted with a literature search in MEDLINE via PubMed for the period July 2000 (first approval of glitazones in the European Union) to the date of the last search (15 July 2024).

Results: The primary literature search yielded 860 hits and ultimately 14 studies were included. Of these, 6 were systematic reviews (5 including meta-analyses) and 8 were translational studies. In the reviews, the data situation regarding the association of glitazones with bladder cancer remains ambiguous, particularly due to the heterogeneity of the underlying studies and numerous confounding factors such as age or smoking history. Experimental evidence of a causal relationship between glitazones and bladder cancer could not be demonstrated. Two included studies even see a possible therapeutic benefit of the preparations in these patients.

Conclusion: It remains unclear whether glitazones play a relevant role in the development of bladder cancer. The possible therapeutic benefit should be urgently investigated further.