Interesting only one study in the meta analysis looking at bladder cancer risk in people using pioglitazone. However it was highly elevated risk of 14 events / 2605 vs control group of 6 events / 2633 and OR of 2.37. But to me it is suspect since it is a relatively small study and the bladder cancer incidence in controls is 3 x higher than other studies just glancing over the list. To me this suggest there may be confounding factors in the population they studied.
Also you have an occasional outlier SGLT2i study showing increased risk but when combined with the other studies the differences average out. OR ranges are huge for the majority of studies meaning the sample sizes need to be much larger to really get a meaningful answer since in most studies the range crosses the 1.0 mark.
Hence the meta analysis that in this case is quite useful and convincing. Makes me wonder about the pioglitazone data. I’d love to see a huge meta on pio like this but it seems people have generally stopped using it since the prevailing view is that it slightly increases the risk of bladder CA.
