Evidence mapPaperPMID 29476615Full record

SynthesisCancer medicine2018

Pioglitazone and bladder cancer risk: a systematic review and meta-analysis.

Huilin Tang, Weilong Shi, Shuangshuang Fu, Tiansheng Wang, Suodi Zhai, Yiqing Song, Jiali Han

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Cancer medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 7 pooled it
5.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 7 syntheses or guidelines pooled it, 143 citations in OpenAlex.

  1. Management of classic lichen planopilaris: The EADV task force on hair diseases position statement.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026
    Guideline
  2. Bladder cancer risk factors: a comprehensive umbrella review of meta-analyses.International journal of surgery (London, England) · 2026
    Pooled it
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  16. Type 2 diabetes in patients undergoing gastric cancer surgery: areas requiring disease-specific glycemic management.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2025
    Review
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Huilin TangDepartment of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
Weilong ShiDepartment of Pharmacy, Peking University Third Hospital, Beijing, China.
Shuangshuang FuSchool of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas.
Tiansheng WangDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Suodi ZhaiDepartment of Pharmacy, Peking University Third Hospital, Beijing, China.
Yiqing SongDepartment of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
Jiali HanDepartment of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.ORCID 0000-0002-8309-7092
Peking University · CNIndiana University Health · USRichard M. Fairbanks Foundation · USThe University of Texas Health Science Center at Houston · USUniversity of North Carolina at Chapel Hill · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Current evidence about the association between pioglitazone and bladder cancer risk remains conflict. We aimed to assess the risk of bladder cancer associated with the use of pioglitazone and identify modifiers that affect the results. We systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception to 25 August 2016 for randomized controlled trials (RCTs) and observational studies that evaluated the association between pioglitazone and bladder cancer risk. Conventional and cumulative meta-analyses were used to calculate the odds ratio (OR) with 95% confidence interval (CI). A restricted spline regression analysis was used to examine the dose-response relationship with a generalized least-squares trend test. We included two RCTs involving 9114 patients and 20 observational studies (n = 4,846,088 individuals). An increased risk of bladder cancer in patients treated with pioglitazone versus placebo was noted from RCTs (OR, 1.84; 95%CI, 0.99 to 3.42). In observational studies, the increased risk of bladder cancer was slight but significant among ever-users of pioglitazone versus never-users (OR, 1.13; 95%CI, 1.03 to 1.25), which appeared to be both time- (P = 0.003) and dose-dependent (P = 0.05). In addition, we observed the association differed by region of studies (Europe, United States, or Asia) or source of funding (sponsored by industry or not). Current evidence suggests that pioglitazone may increase the risk of bladder cancer, possibly in a dose- and time-dependent manner. Patients with long-term and high-dose exposure to pioglitazone should be monitored regularly for signs of bladder cancer.

Indexed as

Diabetes Mellitus, Type 2HumansHypoglycemic AgentsOdds RatioPioglitazoneRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsTime FactorsUrinary Bladder NeoplasmsHypoglycemic AgentsPioglitazoneBladder cancerdose-response relationshipmeta-analysispioglitazone

Identifiers

PMID29476615
PMCPMC5911601
OpenAlexW2789496924

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.