Cancer risk of sulfonylureas in patients with type 2 diabetes mellitus: A systematic review.
BACKGROUND
Increasing evidence suggests that oral hypoglycemic agents used in type 2 diabetes mellitus (T2DM) may affect cancer risk. Sulfonylureas (SUs) are the most frequently used antidiabetic medications for T2DM. Whether using SUs has any effect on cancer has received considerable attention. The aim of this study was to assess the effects of SUs on cancer risk in T2DM patients.


METHODS
Published studies were identified in PubMed, EMBASE, and the Cochrane Register of Clinical Studies, and ClinicalTrials.gov was searched for additional information to identify randomized controlled trials (RCTs), cohort studies, and case-control studies. The abstracts and full text were screened, data collected, and the risk of bias assessed for each individual study.


RESULTS
Seventy-seven studies (33 RCTs, 27 cohort studies, and 17 case-control studies) were analyzed. The RCTs did not report a difference in the risk of malignant tumor between SU-treated T2DM patients and controls (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.78-1.18); cohort studies showed that cancer risk was higher in patients using SUs than metformin (relative risk 1.60 [95%CI 1.37-1.87]; adjusted hazard ratio 1.13 [95%CI 1.06-1.19]), and case-control studies suggested a trend for increased cancer risk in those using SUs compared with non-SU users (adjusted OR 1.13; 95%CI 0.93-1.37).


CONCLUSIONS
The available evidence clearly shows that SUs can significantly increase the risk of cancer compared with metformin. Although the evidence suggests the possibility that SU users may have a higher risk of cancer than those using alternative medications in addition to metformin, it remains inadequate to enable definitive conclusions to be drawn.
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.|Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.
Yuehong
Y
Chen
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Liang
L
Du
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Ling
L
Li
The Second People's Hospital, Mudanjiang, China.
Jun
J
Ma
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Xingyuan
X
Geng
Department of Teaching Affairs, West China Medical School, Sichuan University, Chengdu, China.
Xun
X
Yao
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Guanjian
G
Liu
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.|Centre for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
Xin
X
Sun
D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D009369:Neoplasms / Q000139:chemically induced*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000009:adverse effects*
D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds
2型糖尿病; cancer risk; sulfonylureas; systematic review; type 2 diabetes mellitus; 癌症风险; 磺脲类药物; 系统评价