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Glyburide therapy may increase cancer risk
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An increased risk for cancer was found with longer cumulative durations and higher cumulative doses of glyburide, according to recent study findings published in Diabetes Care.
“The use of glyburide was associated with an overall nonsignificant 9% increased risk of cancer,” the researchers wrote. “In secondary analyses, we observed duration- and dose-response relationships, supporting the hypothesis that the use of glyburide may be associated with an increased risk of cancer. The analysis of the association between glyburide and site-specific cancers generated heterogeneous findings, ranging from a mild protective effect of 7% for lung cancer to a nonsignificant increased risk of 19% for breast cancer.”
Laurent Azoulay
Laurent Azoulay, PhD, MSc, of McGill University in Montreal, and colleagues evaluated data from the U.K. Clinical Practice Research Datalink on 52,600 patients newly prescribed glyburide (n = 3,413) or other second-generation sulfonylureas (n = 49,187) between 2008 and July 2013 to determine the risk for cancer among the treatment groups. Follow-up was conducted for a mean 5.3 years.
During follow-up, 4,105 patients were newly diagnosed with any cancer for a crude incidence rate of 14.6 per 1,000 person-years.
A nonsignificant increased risk for any cancer was found with glyburide compared with other second-generation sulfonylureas (HR = 1.09; 95% CI, 0.98-1.22). Results were similar when varying the lag period to 2 years (HR = 1.09; 95% CI, 0.97-1.22) and 3 years (HR = 1.07; 95% CI, 0.95-1.21).
There was a 21% increased risk for cancer with the use of glyburide for at least 36 months. A dose-response relationship was also found with a 27% increased risk for cancer when there was a cumulative dose of at least 1,096 defined daily doses.
No single cancer type was associated with an increased risk when the analysis was repeated for the four major cancers (prostate, breast, lung and colorectal); however, the HR for breast cancer was elevated (HR = 1.19; 95% CI, 0.78-1.79). Lung cancer risk was under the null and statistically significant (HR = 0.93; 95% CI, 0.88-0.99).
“Additional studies are needed to replicate the findings and assess whether glyburide is associated with an increased risk of a specific cancer,” the researchers wrote. – by Amber Cox
Disclosure: One researcher reports receiving consulting/speaker fees from AstraZeneca, Bristol-Myers Squibb, Merck, Novo Nordisk, Sanofi and Servier.
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