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  • daviscupper daviscupper Jun 27, 2009 9:43 AM Flag

    Unedited Diabetologia Conclusions


    Lantus insulin: a possible link with cancer which requires further investigation

    The European Association for the Study of Diabetes (EASD) today makes an urgent call for more research into a possible link between use of insulin glargine (an insulin analogue, brand name Lantus) and increased risk of cancer, following evidence from studies in Germany, Sweden and Scotland. However, until this further research becomes available, these experts are stressing that patients with diabetes taking Lantus should continue to do so, although some might wish to consider alternative types of insulin. The studies are reported in Diabetologia (the journal of EASD).

    Human insulin has been widely used for decades and its safety is beyond doubt; this new information relates to an artificial form of insulin, or insulin analogue, called insulin glargine (or Lantus insulin) which has been widely used since 2000. The concerns about a possible link between use of Lantus insulin and increased cancer risk were raised by a German study of around 127,000 insulin-treated patients in an insurance database. The research identified a statistically significant link between patients who had used Lantus insulin and those who had been diagnosed with cancer. Compared with people using similar doses of human insulin, out of every 100 people who used Lantus insulin over an average of about one-and-a-half years, one additional person was diagnosed with cancer. Of particular note in this study was the finding that the increased risk of cancer was dose-dependent. Thus for patients given a dose of 10U, Lantus insulin alone increased the risk of cancer by 9% compared with human insulin; but for a dose of 50U, the increased risk was 31%. The study did not consider insulin detemir (Levemir), an insulin analogue whose action is prolonged by a different principle from Lantus.

    Professor Edwin Gale, Editor of Diabetologia, and Professor Ulf Smith, President of EASD, realised the significance of these findings but wanted them replicated in other studies from other European countries before announcing them formally. Studies were thus carried out using databases from Sweden, Scotland, and the UK. The Swedish study found that compared with patients on insulins other than Lantus insulin, patients on lantus insulin alone had double the risk of breast cancer. The Scottish study found a non-significant increased risk for breast cancer specifically. The UK study found no link between insulin glargine and cancer.

    Prof Gale and Prof Smith emphasise the limitations to the studies. The main one is that, although the data were adjusted for a number of variables, the characteristics of the groups of patients taking lantus insulin alone (generally older, higher blood pressure, more overweight) were different to those on other forms of insulin. Thus any difference in cancer risk could be attributed to the pre-treatment characteristics of the groups, rather than the treatment itself. Also, the numbers of cases of breast cancer in the Swedish and Scottish studies were very small, meaning the findings could have occurred due to chance. They state categorically that Lantus and other insulins do not cause cancer, but these studies expose the possibility that Lantus insulin could cause existing cancer cells to grow and divide more rapidly-which might explain why more cancers came to be diagnosed over 1-3 years of observation. They say: "We believe people are entitled to know that use of Lantus insulin might be associated with greater risk, but this must also be balanced against the possibility that we might be causing unnecessary alarm by raising these concerns."

    They say: "A large combined analysis of the best available databases worldwide is the best way forward, and EASD and sanofi-aventis are pledged to carry this investigation forward until we have either confirmed these preliminary observations or, more hopefully, finally put them to rest."

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    • thanks for this posting. Now, based on this, it seems that this is way overblown from 33.5 to 28. The rate of cancer was low beyond low and only in one country and could have been due to external factors and not the treatment. Problem is the market will shoot 1st and ask questions later. Will someone come out and defend SNY??? Upgrade based on BS drop???

      If you ask me, UBS must have shorted like hell and covered and now we ride up. The correlation betweent the drug and cancer is so weak/vague it isn't funny. they even give 50 disclaimers saying there isn't a link and this is just conjecture. Gee, thanks for screaming wolf wall street when a puppy walked across the yard. Idiots.

    • Thanks for the post. I assume that's the latest news. As such I would expect an up day for SNY Monday. However, wasn't the researcher who set this all off doing a study in the US at UT? Nothing about that was mentioned. Perhaps I just jumped to an errant conclusion.

      Surely if the patient groups receiving alternate insulins had different risk factors all this ipso facto statistical reduction is very questionable. One has to remember governments and insurance companies are always looking for justifications to cut drug costs and they have many times in the past come to false conclusions based on such statistical reasoning.

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