Trial Outcomes & Findings for Cohort Study of Pioglitazone and Cancer Incidence in Participants With Diabetes Mellitus. (NCT NCT02958956)

NCT ID: NCT02958956

Last Updated: 2018-03-07

Results Overview

The hazard ratio of the 10 most common cancers: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma associated with ever use of pioglitazone. Cox proportional hazards regression modeling was used to provide point and interval estimates of the relative hazard of the 10 most common cancers associated with ever use of pioglitazone. In all regression analyses, these measures of exposure to pioglitazone were treated as time-dependent covariates and time since entry into the cohort was the time scale.

Recruitment status

COMPLETED

Target enrollment

236507 participants

Primary outcome timeframe

15 years 5 months

Results posted on

2018-03-07

Participant Flow

Participants took part in the study at 2 investigative sites in the United States from 01 July 1997 to 30 June 2012.

Participants with a historical diagnosis of T2DM with pioglitazone exposure identified from the Kaiser Permanente of Northern California(KPNC) Diabetes Registry were enrolled in this observational study.

Participant milestones

Participant milestones
Measure
Ever User of Pioglitazone
Ever user of pioglitazone was defined as having filled 2 prescriptions for the drug within a 6-month period.
Never User of Pioglitazone
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Overall Study
STARTED
38190
198317
Overall Study
COMPLETED
38190
198317
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Cohort Study of Pioglitazone and Cancer Incidence in Participants With Diabetes Mellitus.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ever User of Pioglitazone
n=38190 Participants
Ever user of pioglitazone was defined as having filled 2 prescriptions for the drug within a 6-month period.
Never User of Pioglitazone
n=198317 Participants
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Total
n=236507 Participants
Total of all reporting groups
Age, Continuous
55.6 Years
STANDARD_DEVIATION 10.4 • n=5 Participants
59.7 Years
STANDARD_DEVIATION 12.2 • n=7 Participants
59.0 Years
STANDARD_DEVIATION 12.0 • n=5 Participants
Sex: Female, Male
Female
17632 Participants
n=5 Participants
92552 Participants
n=7 Participants
110184 Participants
n=5 Participants
Sex: Female, Male
Male
20558 Participants
n=5 Participants
105765 Participants
n=7 Participants
126323 Participants
n=5 Participants
Race/Ethnicity, Customized
Non-Hispanic white
18717 Participants
n=5 Participants
99641 Participants
n=7 Participants
118358 Participants
n=5 Participants
Race/Ethnicity, Customized
African American
3667 Participants
n=5 Participants
19931 Participants
n=7 Participants
23598 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian or Pacific Islander
5695 Participants
n=5 Participants
26637 Participants
n=7 Participants
32332 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
5144 Participants
n=5 Participants
21554 Participants
n=7 Participants
26698 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
2129 Participants
n=5 Participants
10549 Participants
n=7 Participants
12678 Participants
n=5 Participants
Race/Ethnicity, Customized
Missing
2838 Participants
n=5 Participants
20005 Participants
n=7 Participants
22843 Participants
n=5 Participants
Smoking
Current smoking
7929 Participants
n=5 Participants
37401 Participants
n=7 Participants
45330 Participants
n=5 Participants
Smoking
Missing
30261 Participants
n=5 Participants
160916 Participants
n=7 Participants
191177 Participants
n=5 Participants
Income
Low
20379 Participants
n=5 Participants
107007 Participants
n=7 Participants
127386 Participants
n=5 Participants
Income
High
17125 Participants
n=5 Participants
86384 Participants
n=7 Participants
103509 Participants
n=5 Participants
Income
Missing
686 Participants
n=5 Participants
4926 Participants
n=7 Participants
5612 Participants
n=5 Participants
Renal function
Normal creatinine
29476 Participants
n=5 Participants
156510 Participants
n=7 Participants
185986 Participants
n=5 Participants
Renal function
Elevated creatinine
1495 Participants
n=5 Participants
16234 Participants
n=7 Participants
17729 Participants
n=5 Participants
Renal function
Missing
7219 Participants
n=5 Participants
25573 Participants
n=7 Participants
32792 Participants
n=5 Participants
Congestive Heart Failure
Congestive Heart Failure
1070 Participants
n=5 Participants
12602 Participants
n=7 Participants
13672 Participants
n=5 Participants
Congestive Heart Failure
Missing
37120 Participants
n=5 Participants
185715 Participants
n=7 Participants
222835 Participants
n=5 Participants
Baseline Glycosylated Hemoglobin (HbA1c)
<7.0 percent (%)
6832 Participants
n=5 Participants
63867 Participants
n=7 Participants
70699 Participants
n=5 Participants
Baseline Glycosylated Hemoglobin (HbA1c)
7.0-7.9%
6594 Participants
n=5 Participants
34579 Participants
n=7 Participants
41173 Participants
n=5 Participants
Baseline Glycosylated Hemoglobin (HbA1c)
8.0-8.9%
4514 Participants
n=5 Participants
17971 Participants
n=7 Participants
22485 Participants
n=5 Participants
Baseline Glycosylated Hemoglobin (HbA1c)
9.0-9.9%
3451 Participants
n=5 Participants
12342 Participants
n=7 Participants
15793 Participants
n=5 Participants
Baseline Glycosylated Hemoglobin (HbA1c)
>=10.0%
8390 Participants
n=5 Participants
29836 Participants
n=7 Participants
38226 Participants
n=5 Participants
Baseline Glycosylated Hemoglobin (HbA1c)
Missing
8409 Participants
n=5 Participants
39722 Participants
n=7 Participants
48131 Participants
n=5 Participants
Time since diabetes diagnosis
0-4 years
22835 Participants
n=5 Participants
134209 Participants
n=7 Participants
157044 Participants
n=5 Participants
Time since diabetes diagnosis
5-9 years
3148 Participants
n=5 Participants
9554 Participants
n=7 Participants
12702 Participants
n=5 Participants
Time since diabetes diagnosis
>= 10 years
2993 Participants
n=5 Participants
17300 Participants
n=7 Participants
20293 Participants
n=5 Participants
Time since diabetes diagnosis
Missing
9214 Participants
n=5 Participants
37254 Participants
n=7 Participants
46468 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 15 years 5 months

Population: Analysis population included T2DM participants who were identified from the KPNC Diabetes Registry in the study 1.

The hazard ratio of the 10 most common cancers: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma associated with ever use of pioglitazone. Cox proportional hazards regression modeling was used to provide point and interval estimates of the relative hazard of the 10 most common cancers associated with ever use of pioglitazone. In all regression analyses, these measures of exposure to pioglitazone were treated as time-dependent covariates and time since entry into the cohort was the time scale.

Outcome measures

Outcome measures
Measure
Full Cohort
n=236507 Participants
Participants with diabetes who were members of the KPNC registry, who received (ever use) at least 2 prescriptions for pioglitazone within a 6-month period or who did not receive pioglitazone were followed up to 15.5 years (1997-2012) in this observational study.
Never User of Pioglitazone
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Prostate
1.13 Ratio
Interval 1.02 to 1.26
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Breast
1.00 Ratio
Interval 0.88 to 1.13
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Lung/Bronchus
1.00 Ratio
Interval 0.87 to 1.15
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Colon
0.91 Ratio
Interval 0.78 to 1.05
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Non-Hodgkin Lymphoma
1.00 Ratio
Interval 0.81 to 1.23
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Corpus Uteri
0.88 Ratio
Interval 0.71 to 1.09
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Pancreatic
1.41 Ratio
Interval 1.16 to 1.71
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Kidney/Renal Pelvis
0.95 Ratio
Interval 0.76 to 1.18
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Rectum
0.81 Ratio
Interval 0.6 to 1.08
Hazard Ratio of the 10 Most Common Cancers Associated With Ever Use of Pioglitazone
Melanoma
1.15 Ratio
Interval 0.91 to 1.46

PRIMARY outcome

Timeframe: 15 years 5 months

Population: Analysis population included T2DM participants who were identified from the KPNC Diabetes Registry in the study 1.

Number of 10 most common cancer cases are reported in this measure: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma.

Outcome measures

Outcome measures
Measure
Full Cohort
n=38190 Participants
Participants with diabetes who were members of the KPNC registry, who received (ever use) at least 2 prescriptions for pioglitazone within a 6-month period or who did not receive pioglitazone were followed up to 15.5 years (1997-2012) in this observational study.
Never User of Pioglitazone
n=198317 Participants
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Number of 10 Most Common Cancers Associated Cases
Prostate
476 Cases
3307 Cases
Number of 10 Most Common Cancers Associated Cases
Breast
320 Cases
2478 Cases
Number of 10 Most Common Cancers Associated Cases
Lung/Bronchus
282 Cases
2300 Cases
Number of 10 Most Common Cancers Associated Cases
Colon
233 Cases
1844 Cases
Number of 10 Most Common Cancers Associated Cases
Non-Hodgkin Lymphoma
120 Cases
839 Cases
Number of 10 Most Common Cancers Associated Cases
Corpus Uteri
118 Cases
799 Cases
Number of 10 Most Common Cancers Associated Cases
Pancreatic
164 Cases
648 Cases
Number of 10 Most Common Cancers Associated Cases
Kidney/Renal Pelvis
110 Cases
690 Cases
Number of 10 Most Common Cancers Associated Cases
Rectum
59 Cases
570 Cases
Number of 10 Most Common Cancers Associated Cases
Melanoma
102 Cases
594 Cases

SECONDARY outcome

Timeframe: 15 years 5 months

Population: Analysis population included T2DM participants who were identified from the KPNC Diabetes Registry in the study 1.

The hazard ratio of the 10 most common cancers: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma associated with time since first use of pioglitazone. The various times since initiation include \<12 months ago, 12-23 months ago, 24-35 months ago, 36-47 months ago, 48-83 months ago and 84+ months ago. Cox proportional hazards regression modeling was used to provide point and interval estimates of the time since first use. In all regression analyses, these measures of exposure to pioglitazone were treated as time-dependent covariates and time since entry into the cohort was the time scale.

Outcome measures

Outcome measures
Measure
Full Cohort
n=236507 Participants
Participants with diabetes who were members of the KPNC registry, who received (ever use) at least 2 prescriptions for pioglitazone within a 6-month period or who did not receive pioglitazone were followed up to 15.5 years (1997-2012) in this observational study.
Never User of Pioglitazone
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Corpus Uteri: 24-35 months ago
0.65 Ratio
Interval 0.37 to 1.16
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Prostate: <12 months ago
0.92 Ratio
Interval 0.73 to 1.17
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Prostate: 12-23 months ago
1.18 Ratio
Interval 0.94 to 1.47
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Prostate: 24-35 months ago
1.21 Ratio
Interval 0.96 to 1.52
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Prostate: 36-47 months ago
1.36 Ratio
Interval 1.07 to 1.71
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Prostate: 48-83 months ago
1.04 Ratio
Interval 0.86 to 1.26
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Prostate: 84+ months ago
1.23 Ratio
Interval 0.95 to 1.59
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Breast: <12 months ago
1.00 Ratio
Interval 0.76 to 1.31
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Breast: 12-23 months ago
0.84 Ratio
Interval 0.62 to 1.14
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Breast: 24-35 months ago
1.04 Ratio
Interval 0.77 to 1.39
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Breast: 36-47 months ago
0.77 Ratio
Interval 0.54 to 1.1
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Breast: 48-83 months ago
1.03 Ratio
Interval 0.83 to 1.28
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Breast: 84+ months ago
1.38 Ratio
Interval 1.06 to 1.8
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Lung/Bronchus: <12 months ago
0.82 Ratio
Interval 0.59 to 1.14
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Lung/Bronchus: 12-23 months ago
1.12 Ratio
Interval 0.84 to 1.5
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Lung/Bronchus: 24-35 months ago
1.13 Ratio
Interval 0.84 to 1.53
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Lung/Bronchus: 36-47 months ago
1.04 Ratio
Interval 0.75 to 1.45
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Lung/Bronchus: 48-83 months ago
0.95 Ratio
Interval 0.74 to 1.2
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Lung/Bronchus: 84+ months ago
0.96 Ratio
Interval 0.7 to 1.31
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Colon: <12 months ago
0.62 Ratio
Interval 0.41 to 0.92
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Colon: 12-23 months ago
0.79 Ratio
Interval 0.55 to 1.14
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Colon: 24-35 months ago
1.35 Ratio
Interval 1.0 to 1.81
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Colon: 36-47 months ago
0.81 Ratio
Interval 0.55 to 1.19
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Colon: 48-83 months ago
0.97 Ratio
Interval 0.76 to 1.24
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Colon: 84+ months ago
0.79 Ratio
Interval 0.56 to 1.12
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: <12 months ago
1.15 Ratio
Interval 0.75 to 1.76
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 12-23 months ago
1.44 Ratio
Interval 0.97 to 2.14
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 24-35 months ago
0.92 Ratio
Interval 0.56 to 1.53
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 36-47 months ago
0.79 Ratio
Interval 0.44 to 1.4
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 48-83 months ago
0.70 Ratio
Interval 0.46 to 1.06
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 84+ months ago
0.98 Ratio
Interval 0.61 to 1.56
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Corpus Uteri: <12 months ago
0.91 Ratio
Interval 0.58 to 1.43
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Corpus Uteri: 12-23 months ago
0.97 Ratio
Interval 0.62 to 1.53
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Corpus Uteri: 36-47 months ago
0.90 Ratio
Interval 0.54 to 1.52
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Corpus Uteri: 48-83 months ago
0.99 Ratio
Interval 0.7 to 1.41
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Corpus Uteri: 84+ months ago
0.94 Ratio
Interval 0.59 to 1.51
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Pancreatic: <12 months ago
2.27 Ratio
Interval 1.61 to 3.2
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Pancreatic: 12-23 months ago
1.31 Ratio
Interval 0.85 to 2.01
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Pancreatic: 24-35 months ago
1.13 Ratio
Interval 0.71 to 1.82
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Pancreatic: 36-47 months ago
1.28 Ratio
Interval 0.8 to 2.04
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Pancreatic: 48-83 months ago
1.14 Ratio
Interval 0.82 to 1.6
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Pancreatic: 84+ months ago
1.39 Ratio
Interval 0.93 to 2.07
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: <12 months ago
0.75 Ratio
Interval 0.43 to 1.3
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 12-23 months ago
0.59 Ratio
Interval 0.32 to 1.11
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 24-35 months ago
1.14 Ratio
Interval 0.71 to 1.83
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 36-47 months ago
1.16 Ratio
Interval 0.71 to 1.9
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 48-83 months ago
1.01 Ratio
Interval 0.71 to 1.44
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 84+ months ago
0.90 Ratio
Interval 0.55 to 1.5
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Rectum: <12 months ago
0.67 Ratio
Interval 0.34 to 1.29
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Rectum: 12-23 months ago
0.65 Ratio
Interval 0.32 to 1.31
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Rectum: 24-35 months ago
1.02 Ratio
Interval 0.56 to 1.86
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Rectum: 36-47 months ago
1.27 Ratio
Interval 0.71 to 2.27
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Rectum: 48-83 months ago
0.60 Ratio
Interval 0.33 to 1.08
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Rectum: 84+ months ago
0.87 Ratio
Interval 0.42 to 1.81
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Melanoma: <12 months ago
1.03 Ratio
Interval 0.6 to 1.76
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Melanoma: 12-23 months ago
1.37 Ratio
Interval 0.85 to 2.21
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Melanoma: 24-35 months ago
1.02 Ratio
Interval 0.57 to 1.83
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Melanoma: 36-47 months ago
1.45 Ratio
Interval 0.87 to 2.4
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Melanoma: 48-83 months ago
0.96 Ratio
Interval 0.62 to 1.47
Hazard Ratio of the 10 Most Common Cancers Associated With Time Since First Use of Pioglitazone
Melanoma: 84+ months ago
1.47 Ratio
Interval 0.91 to 2.36

SECONDARY outcome

Timeframe: 15 years 5 months

Population: Analysis population included T2DM participants who were identified from the KPNC Diabetes Registry in the study 1. The unexposed arm was not planned to be analyzed for this outcome measure.

Number of 10 most common cancer cases: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma associated with time since first use of pioglitazone. Time since initiation of pioglitazone was categorized as \<12 months ago, 12-23 months ago, 24-35 months ago, 36-47 months ago, 48-83 months ago and 84+ months ago.

Outcome measures

Outcome measures
Measure
Full Cohort
n=38190 Participants
Participants with diabetes who were members of the KPNC registry, who received (ever use) at least 2 prescriptions for pioglitazone within a 6-month period or who did not receive pioglitazone were followed up to 15.5 years (1997-2012) in this observational study.
Never User of Pioglitazone
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Prostate: <12 months ago
55 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Prostate: 12-23 months ago
82 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Prostate: 24-35 months ago
76 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Prostate: 36-47 months ago
75 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Prostate: 48-83 months ago
119 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Prostate: 84+ months ago
69 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Breast: <12 months ago
42 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Breast: 12-23 months ago
42 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Breast: 24-35 months ago
47 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Breast: 36-47 months ago
31 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Breast: 48-83 months ago
91 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Breast: 84+ months ago
67 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Lung/Bronchus: <12 months ago
32 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Lung/Bronchus: 12-23 months ago
48 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Lung/Bronchus: 24-35 months ago
45 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Lung/Bronchus: 36-47 months ago
37 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Lung/Bronchus: 48-83 months ago
75 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Lung/Bronchus: 84+ months ago
45 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Colon: <12 months ago
22 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Colon: 12-23 months ago
30 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Colon: 24-35 months ago
47 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Colon: 36-47 months ago
26 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Colon: 48-83 months ago
71 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Colon: 84+ months ago
37 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: <12 months ago
21 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 12-23 months ago
26 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 24-35 months ago
16 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 36-47 months ago
12 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 48-83 months ago
24 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Non-Hodgkin Lymphoma: 84+ months ago
21 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Corpus Uteri: <12 months ago
14 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Corpus Uteri: 12-23 months ago
20 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Corpus Uteri: 24-35 months ago
12 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Corpus Uteri: 36-47 months ago
15 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Corpus Uteri: 48-83 months ago
36 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Corpus Uteri: 84+ months ago
21 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Pancreatic: <12 months ago
33 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Pancreatic: 12-23 months ago
22 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Pancreatic: 24-35 months ago
18 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Pancreatic: 36-47 months ago
19 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Pancreatic: 48-83 months ago
41 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Pancreatic: 84+ months ago
31 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: <12 months ago
12 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 12-23 months ago
10 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 24-35 months ago
18 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 36-47 months ago
17 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 48-83 months ago
35 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Kidney/Renal Pelvis: 84+ months ago
18 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Rectum: <12 months ago
8 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Rectum: 12-23 months ago
8 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Rectum: 24-35 months ago
11 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Rectum: 36-47 months ago
12 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Rectum: 48-83 months ago
12 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Rectum: 84+ months ago
8 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Melanoma: <12 months ago
10 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Melanoma: 12-23 months ago
18 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Melanoma: 24-35 months ago
12 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Melanoma: 36-47 months ago
16 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Melanoma: 48-83 months ago
24 Cases
Number of 10 Most Common Cancers Cases by Time Since First Use of Pioglitazone
Melanoma: 84+ months ago
22 Cases

SECONDARY outcome

Timeframe: 15 years 5 months

Population: Analysis population included T2DM participants who were identified from the KPNC Diabetes Registry in the study 1.

The hazard ratio of the 10 most common cancers: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma associated with duration of pioglitazone. The duration of pioglitazone was categorized as \<12 months, 12-23 months, 24-35 months, 36-59 months, 60+ months. Cox proportional hazards regression modeling was used to provide point and interval estimates of the cumulative duration. In all regression analyses, these measures of exposure to pioglitazone were treated as time-dependent covariates and time since entry into the cohort was the time scale.

Outcome measures

Outcome measures
Measure
Full Cohort
n=236507 Participants
Participants with diabetes who were members of the KPNC registry, who received (ever use) at least 2 prescriptions for pioglitazone within a 6-month period or who did not receive pioglitazone were followed up to 15.5 years (1997-2012) in this observational study.
Never User of Pioglitazone
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Prostate: <12 months
1.00 Ratio
Interval 0.84 to 1.19
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Prostate: 12-23 months
1.30 Ratio
Interval 1.08 to 1.57
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Prostate: 24-35 months
1.07 Ratio
Interval 0.84 to 1.35
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Prostate: 36-59 months
1.18 Ratio
Interval 0.96 to 1.45
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Prostate: 60+ months
1.16 Ratio
Interval 0.9 to 1.5
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Breast: <12 months
0.84 Ratio
Interval 0.69 to 1.03
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Breast: 12-23 months
1.07 Ratio
Interval 0.84 to 1.35
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Breast: 24-35 months
1.01 Ratio
Interval 0.75 to 1.35
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Breast: 36-59 months
1.06 Ratio
Interval 0.82 to 1.38
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Breast: 60+ months
1.25 Ratio
Interval 0.93 to 1.68
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Lung/Bronchus: <12 months
0.90 Ratio
Interval 0.73 to 1.12
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Lung/Bronchus: 12-23 months
0.98 Ratio
Interval 0.75 to 1.27
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Lung/Bronchus: 24-35 months
0.96 Ratio
Interval 0.7 to 1.31
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Lung/Bronchus: 36-59 months
1.06 Ratio
Interval 0.81 to 1.4
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Lung/Bronchus: 60+ months
1.12 Ratio
Interval 0.81 to 1.54
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Colon: <12 months
0.86 Ratio
Interval 0.68 to 1.08
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Colon: 12-23 months
0.88 Ratio
Interval 0.66 to 1.18
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Colon: 24-35 months
1.03 Ratio
Interval 0.75 to 1.42
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Colon: 36-59 months
0.66 Ratio
Interval 0.46 to 0.94
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Colon: 60+ months
1.05 Ratio
Interval 0.76 to 1.46
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Non-Hodgkin Lymphoma: <12 months
0.93 Ratio
Interval 0.66 to 1.29
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Non-Hodgkin Lymphoma: 12-23 months
1.25 Ratio
Interval 0.87 to 1.8
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Non-Hodgkin Lymphoma: 24-35 months
1.08 Ratio
Interval 0.69 to 1.7
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Non-Hodgkin Lymphoma: 36-59 months
0.72 Ratio
Interval 0.44 to 1.18
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Non-Hodgkin Lymphoma: 60+ months
0.89 Ratio
Interval 0.53 to 1.49
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Corpus Uteri: <12 months
1.01 Ratio
Interval 0.75 to 1.35
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Corpus Uteri: 12-23 months
0.83 Ratio
Interval 0.55 to 1.25
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Corpus Uteri: 24-35 months
0.97 Ratio
Interval 0.61 to 1.55
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Corpus Uteri: 36-59 months
0.78 Ratio
Interval 0.49 to 1.24
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Corpus Uteri: 60+ months
0.73 Ratio
Interval 0.42 to 1.29
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Pancreatic: <12 months
1.48 Ratio
Interval 1.12 to 1.95
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Pancreatic: 12-23 months
1.19 Ratio
Interval 0.82 to 1.73
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Pancreatic: 24-35 months
1.03 Ratio
Interval 0.64 to 1.66
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Pancreatic: 36-59 months
1.63 Ratio
Interval 1.15 to 2.31
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Pancreatic: 60+ months
1.53 Ratio
Interval 1.0 to 2.33
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Kidney/Renal Pelvis: <12 months
0.92 Ratio
Interval 0.65 to 1.3
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Kidney/Renal Pelvis: 12-23 months
0.81 Ratio
Interval 0.52 to 1.27
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Kidney/Renal Pelvis: 24-35 months
0.96 Ratio
Interval 0.59 to 1.57
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Kidney/Renal Pelvis: 36-59 months
0.99 Ratio
Interval 0.64 to 1.52
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Kidney/Renal Pelvis: 60+ months
1.03 Ratio
Interval 0.63 to 1.68
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Rectum: <12 months
0.87 Ratio
Interval 0.57 to 1.33
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Rectum: 12-23 months
0.78 Ratio
Interval 0.45 to 1.37
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Rectum: 24-35 months
0.80 Ratio
Interval 0.41 to 1.56
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Rectum: 36-59 months
0.58 Ratio
Interval 0.29 to 1.18
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Rectum: 60+ months
0.89 Ratio
Interval 0.43 to 1.82
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Melanoma: <12 months
1.06 Ratio
Interval 0.73 to 1.54
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Melanoma: 12-23 months
1.59 Ratio
Interval 1.08 to 2.33
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Melanoma: 24-35 months
1.06 Ratio
Interval 0.62 to 1.81
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Melanoma: 36-59 months
0.80 Ratio
Interval 0.46 to 1.37
Hazard Ratio of the 10 Most Common Cancers Associated With Duration of Pioglitazone
Melanoma: 60+ months
1.46 Ratio
Interval 0.91 to 2.35

SECONDARY outcome

Timeframe: 15 years 5 months

Population: Analysis population included T2DM participants who were identified from the KPNC Diabetes Registry in the study 1. The unexposed arm was not planned to be analyzed for this outcome measure.

The 10 most common cancer cases included: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma associated with duration of pioglitazone. The duration of pioglitazone was categorized as \<12 months, 12-23 months, 24-35 months, 36-59 months, 60+ months.

Outcome measures

Outcome measures
Measure
Full Cohort
n=38190 Participants
Participants with diabetes who were members of the KPNC registry, who received (ever use) at least 2 prescriptions for pioglitazone within a 6-month period or who did not receive pioglitazone were followed up to 15.5 years (1997-2012) in this observational study.
Never User of Pioglitazone
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Kidney/Renal Pelvis: 36-59 months
23 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Prostate: <12 months
118 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Prostate: 12-23 months
121 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Prostate: 24-35 months
72 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Prostate: 36-59 months
99 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Prostate: 60+ months
66 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Breast: <12 months
88 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Breast: 12-23 months
75 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Breast: 24-35 months
47 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Breast: 36-59 months
61 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Breast: 60+ months
49 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Lung/Bronchus: <12 months
83 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Lung/Bronchus: 12-23 months
60 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Lung/Bronchus: 24-35 months
41 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Lung/Bronchus: 36-59 months
56 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Lung/Bronchus: 60+ months
42 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Colon: <12 months
72 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Colon: 12-23 months
48 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Colon: 24-35 months
40 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Colon: 36-59 months
33 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Colon: 60+ months
40 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Non-Hodgkin Lymphoma: <12 months
35 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Non-Hodgkin Lymphoma: 12-23 months
32 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Non-Hodgkin Lymphoma: 24-35 months
20 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Non-Hodgkin Lymphoma: 36-59 months
17 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Non-Hodgkin Lymphoma: 60+ months
16 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Corpus Uteri: <12 months
43 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Corpus Uteri: 12-23 months
24 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Corpus Uteri: 24-35 months
19 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Corpus Uteri: 36-59 months
19 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Corpus Uteri: 60+ months
13 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Pancreatic: <12 months
54 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Pancreatic: 12-23 months
28 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Pancreatic: 24-35 months
18 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Pancreatic: 36-59 months
36 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Pancreatic: 60+ months
25 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Kidney/Renal Pelvis: <12 months
32 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Kidney/Renal Pelvis: 12-23 months
20 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Kidney/Renal Pelvis: 24-35 months
17 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Kidney/Renal Pelvis: 60+ months
18 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Rectum: <12 months
21 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Rectum: 12-23 months
13 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Rectum: 24-35 months
9 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Rectum: 36-59 months
8 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Rectum: 60+ months
8 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Melanoma: <12 months
25 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Melanoma: 12-23 months
29 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Melanoma: 24-35 months
14 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Melanoma: 36-59 months
14 Cases
Number of 10 Most Common Cancer Cases by Duration of Pioglitazone
Melanoma: 60+ months
20 Cases

SECONDARY outcome

Timeframe: 15 years 5 months

Population: Analysis population included T2DM participants who were identified from the KPNC Diabetes Registry in the study 1.

The hazard ratio of the 10 most common cancers: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma associated with dose of pioglitazone. The various doses include 1-9000 mg, 9001-25000 mg, 25001-50000 milligram (mg) and greater than or equal to (\>=) 50001 mg. Cox proportional hazards regression modeling was used to provide point and interval estimates of the dose. In all regression analyses, these measures of exposure to pioglitazone were treated as time-dependent covariates and time since entry into the cohort was the time scale.

Outcome measures

Outcome measures
Measure
Full Cohort
n=236507 Participants
Participants with diabetes who were members of the KPNC registry, who received (ever use) at least 2 prescriptions for pioglitazone within a 6-month period or who did not receive pioglitazone were followed up to 15.5 years (1997-2012) in this observational study.
Never User of Pioglitazone
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Prostate: 1-9000 mg
1.08 Ratio
Interval 0.91 to 1.27
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Prostate: 9001-25000 mg
1.24 Ratio
Interval 1.06 to 1.46
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Prostate: 25001-50000 mg
1.12 Ratio
Interval 0.92 to 1.37
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Prostate: >=50001 mg
1.00 Ratio
Interval 0.78 to 1.28
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Breast: 1-9000 mg
0.89 Ratio
Interval 0.73 to 1.08
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Breast: 9001-25000 mg
0.95 Ratio
Interval 0.77 to 1.17
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Breast: 25001-50000 mg
1.15 Ratio
Interval 0.91 to 1.46
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Breast: >=50001 mg
1.19 Ratio
Interval 0.89 to 1.57
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Lung/Bronchus: 1-9000 mg
0.98 Ratio
Interval 0.8 to 1.21
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Lung/Bronchus: 9001-25000 mg
0.91 Ratio
Interval 0.73 to 1.15
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Lung/Bronchus: 25001-50000 mg
0.97 Ratio
Interval 0.75 to 1.26
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Lung/Bronchus: >=50001 mg
1.12 Ratio
Interval 0.84 to 1.5
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Colon: 1-9000 mg
0.87 Ratio
Interval 0.69 to 1.1
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Colon: 9001-25000 mg
0.86 Ratio
Interval 0.68 to 1.1
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Colon: 25001-50000 mg
0.97 Ratio
Interval 0.74 to 1.27
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Colon: >=50001 mg
0.79 Ratio
Interval 0.56 to 1.12
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Non-Hodgkin Lymphoma: 1-9000 mg
0.92 Ratio
Interval 0.66 to 1.29
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Non-Hodgkin Lymphoma: 9001-25000 mg
1.16 Ratio
Interval 0.85 to 1.59
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Non-Hodgkin Lymphoma: 25001-50000 mg
1.02 Ratio
Interval 0.69 to 1.51
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Non-Hodgkin Lymphoma: >=50001 mg
0.66 Ratio
Interval 0.38 to 1.13
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Corpus Uteri: 1-9000 mg
1.02 Ratio
Interval 0.76 to 1.37
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Corpus Uteri: 9001-25000 mg
0.90 Ratio
Interval 0.64 to 1.25
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Corpus Uteri: 25001-50000 mg
0.67 Ratio
Interval 0.42 to 1.06
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Corpus Uteri: >=50001 mg
0.87 Ratio
Interval 0.54 to 1.42
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Pancreatic: 1-9000 mg
1.50 Ratio
Interval 1.14 to 1.98
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Pancreatic: 9001-25000 mg
1.10 Ratio
Interval 0.79 to 1.53
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Pancreatic: 25001-50000 mg
1.46 Ratio
Interval 1.04 to 2.06
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Pancreatic: >=50001 mg
1.61 Ratio
Interval 1.1 to 2.35
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Kidney/Renal Pelvis: 1-9000 mg
0.83 Ratio
Interval 0.57 to 1.19
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Kidney/Renal Pelvis: 9001-25000 mg
1.03 Ratio
Interval 0.73 to 1.44
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Kidney/Renal Pelvis: 25001-50000 mg
0.86 Ratio
Interval 0.56 to 1.32
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Kidney/Renal Pelvis: >=50001 mg
1.05 Ratio
Interval 0.67 to 1.64
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Rectum: 1-9000 mg
0.84 Ratio
Interval 0.54 to 1.3
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Rectum: 9001-25000 mg
0.76 Ratio
Interval 0.47 to 1.23
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Rectum: 25001-50000 mg
0.75 Ratio
Interval 0.42 to 1.34
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Rectum: >=50001 mg
0.82 Ratio
Interval 0.41 to 1.61
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Melanoma: 1-9000 mg
1.20 Ratio
Interval 0.84 to 1.72
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Melanoma: 9001-25000 mg
1.26 Ratio
Interval 0.88 to 1.81
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Melanoma: 25001-50000 mg
1.03 Ratio
Interval 0.66 to 1.62
Hazard Ratio of the 10 Most Common Cancers Associated With Cumulative Dose of Pioglitazone
Melanoma: >=50001 mg
1.14 Ratio
Interval 0.7 to 1.85

SECONDARY outcome

Timeframe: 15 years 5 months

Population: Analysis population included T2DM participants who were identified from the KPNC Diabetes Registry in the study 1.The unexposed arm was not planned to be analyzed for this outcome measure.

The 10 most common cancer cases included: prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectal, and melanoma associated with dose of pioglitazone. The various doses include 1-9000 mg, 9001-25000 mg, 25001-50000 mg and \>=50001 mg.

Outcome measures

Outcome measures
Measure
Full Cohort
n=38190 Participants
Participants with diabetes who were members of the KPNC registry, who received (ever use) at least 2 prescriptions for pioglitazone within a 6-month period or who did not receive pioglitazone were followed up to 15.5 years (1997-2012) in this observational study.
Never User of Pioglitazone
Never user of pioglitazone, which included participants receiving no diabetes medications, with fewer than 2 pioglitazone prescription fills in a 6-month period, and with use of diabetes medications other than pioglitazone.
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Kidney/Renal Pelvis: >=50001 mg
22 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Prostate: 1-9000 mg
129 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Prostate: 9001-25000 mg
167 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Prostate: 25001-50000 mg
109 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Prostate: >=50001 mg
71 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Breast: 1-9000 mg
92 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Breast: 9001-25000 mg
98 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Breast: 25001-50000 mg
77 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Breast: >=50001 mg
53 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Lung/Bronchus: 1-9000 mg
90 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Lung/Bronchus: 9001-25000 mg
81 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Lung/Bronchus: 25001-50000 mg
61 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Lung/Bronchus: >=50001 mg
50 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Colon: 1-9000 mg
72 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Colon: 9001-25000 mg
70 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Colon: 25001-50000 mg
56 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Colon: >=50001 mg
35 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Non-Hodgkin Lymphoma: 1-9000 mg
34 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Non-Hodgkin Lymphoma: 9001-25000 mg
44 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Non-Hodgkin Lymphoma: 25001-50000 mg
28 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Non-Hodgkin Lymphoma: >=50001 mg
14 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Corpus Uteri: 1-9000 mg
43 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Corpus Uteri: 9001-25000 mg
38 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Corpus Uteri: 25001-50000 mg
19 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Corpus Uteri: >=50001 mg
18 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Pancreatic: 1-9000 mg
52 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Pancreatic: 9001-25000 mg
39 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Pancreatic: 25001-50000 mg
38 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Pancreatic: >=50001 mg
32 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Kidney/Renal Pelvis: 1-9000 mg
28 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Kidney/Renal Pelvis: 9001-25000 mg
37 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Kidney/Renal Pelvis: 25001-50000 mg
23 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Rectum: 1-9000 mg
20 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Rectum: 9001-25000 mg
18 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Rectum: 25001-50000 mg
12 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Rectum: >=50001 mg
9 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Melanoma: 1-9000 mg
28 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Melanoma: 9001-25000 mg
34 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Melanoma: 25001-50000 mg
21 Cases
Number of 10 Most Common Cancer Cases By Dose of Pioglitazone
Melanoma: >=50001 mg
19 Cases

Adverse Events

Ever User of Pioglitazone

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Never User of Pioglitazone

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Medical Director

Takeda

Phone: +1-877-825-3327

Results disclosure agreements

  • Principal investigator is a sponsor employee No publication related to study results will be published prior to publication of a multi-center report submitted for publication within 18 months after conclusion or termination of a study at all study sites. Results publications will be submitted to sponsor for review 60 days in advance of publication. Sponsor can require removal of confidential information unrelated to study results. Sponsor can embargo a proposed publication for another 60 days to preserve intellectual property.
  • Publication restrictions are in place

Restriction type: OTHER