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Sulphonylureas and cancer: a case–control study

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This study was aimed at the assessment of incidence of malignancies in type 2 diabetic patients treated with different sulphonylureas. A matched case–control study was performed. Cases were 195 diabetic patients aged 69.0 ± 9.2 years who had an incident malignancy. Controls were 195 diabetic patients, unaffected by cancer, who were matched with the corresponding case for age, sex, duration of diabetes, BMI, HbA1c, comorbidity, smoking and alcohol abuse. Exposure to hypoglycaemic drugs during the 10 years preceding the event (or matching index date) was assessed. After adjusting for concomitant therapies, exposure to metformin and gliclazide for more than 36 months was associated with a significant reduction in the risk of cancer (adj. ORs with 95% CI: 0.28 (0.13–0.57), p < 0.001, and 0.40 (0.21–0.57), p = 0.004, respectively). Conversely, use of glibenclamide for at least 36 months was associated with increased incidence of malignancies (adj. OR 2.62 (1.26–5.42); p = 0.009). Treatment with insulin, thiazolidinediones, or acarbose, was not associated with significant differences in the incidence of cancer. Long-term treatments with individual sulphonylureas could have differential effects on the risk of cancer. In particular, the possible protective effect of gliclazide, as well as the risk associated with glibenclamide, deserves further investigation.

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Conflict of interest statement

Dr. Matteo Monami (MD, PhD) received: (1) speaking fees from Guidotti, Eli Lilly, Merck Sharpe & Dome, Menarini, and Takeda. (2) consultancy fees from Sanofi Aventis and Menarini. Dr. Caterina Lamanna (MD) received: consultancy fees from Merck Sharp & Dome. Dr. Daniela Balzi (MD) has no conflict of interests. Dr. Alberto Marsilii (MD) has no conflict of interests. Prof. Niccolò Marchionni (MD) received: (1) speaking fees from Glaxo Smith and Kline, Guidotti, and Menarini. (2) research grants from Novartis, Novo Nordisk, Sanofi Aventis, Takeda. Dr. Edoardo Mannucci (MD) received: (1) speaking fees from Abiogen Pharma, Glaxo-Smith-Kline, Guidotti, Eli Lilly, Menarini, Merck Sharp & Dome, Merck KgA, Novo Nordisk, Sanofi Aventis, and Takeda. (2) consultancy fees from Sanofi Aventis. (3) research grants from Novartis, Novo Nordisk, Sanofi Aventis, and Takeda. Dr. Mannucci had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Edoardo Mannucci.

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Monami, M., Lamanna, C., Balzi, D. et al. Sulphonylureas and cancer: a case–control study. Acta Diabetol 46, 279–284 (2009).

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