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Is There an Increased Risk of Cancer Associated with Glyburide Treatment?

Researchers are interested in finding whether the use of glyburide is associated with an increased risk of cancer among type 2 diabetic patients compared with the use of other second-generation sulfonylureas. Therefore, a cohort study was performed among 52,600 patients who were newly prescribed either of these agents between January 1988 and 31 July 2013.

A secondary analysis was performed to observe if there was a correlation between the cumulative duration of use and cumulative dose. Then, a follow-up was performed for an estimated five years. The sample population was broken down by glyburide treatment (n=3,413) or other second-generation sulfonylureas (n=49,187) between 2008 and July 2013 to determine risk for cancer.

There was a non-significant increase in the risk of cancer represented by 9%. This was observed with the use of glyburide inclusive. However, findings from the secondary analyses support that the use of glyburide may be associated with an increased risk of cancer. This finding was observed with the dose-response and duration-response correlation.

A rough incidence of 14 per 1000 person-years was newly diagnosed with any type of cancer during the follow-up study, which correlates to 4,105 patients. Comparing glyburide with use of other second-generation sulfonylureas, a non-significant increased risk of cancer was associated with glyburide (HR = 1.09; 95% CI, 0.98-1.22). After fluctuating a lag period to two years, researchers found the results to be similar. The use of glyburide for at least 36 months showed a correlation of 21% increased risk for cancer. A dose-response was also found to have a 27% increased risk of cancer.

 

Overall, researchers believe that additional studies need to be performed in order to validate findings to assess if the use of glyburide has association for a specific type of cancer. In the study performed, when researchers repeated analysis with four major cancers such as prostate, breast, lung, and colorectal, they found that no single cancer type had a correlation for increased risk. Nonetheless, hazard ratio for breast cancer was elevated, and lung cancer risk was under the null and statistically significant.

Practice Pearls:

  • Analysis with four major cancers (prostate, breast, lung, and colorectal) do not show an increased risk for any single cancer type.
  • According to this cohort study, greater cumulative duration and doses of glyburide were associated with an increased risk of cancer.
  • Additional studies need to be conducted to validate and assess these findings, and if the use of glyburide is associated with a specific type of cancer.

Tuccori, Marco, et al. “The Use of Glyburide Compared With Other Sulfonylureas and the Risk of Cancer in Patients With Type 2 Diabetes.” Diabetes care (2015): dc151358