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A new study finds even more evidence to link the use of diabetes drug Actos and the increased risk of bladder cancer.

Actos (pioglitazone) increases the risk of bladder cancer by 63 percent, according to Canadian researchers. The findings, published in the March 30 in the BMJ, stem from an analysis of nearly 146,000 patients treated between 2000 and 2013.

Moreover the data showed that bladder cancer risk increases if Actos is used for two years or more, or if someone takes more than 28,000 mg over the course of their lifetime.

“It appears to be a drug-specific effect, not a class effect,” said senior researcher Laurent Azoulay, an associate professor of oncology at McGill University in Montreal.

Although the risk is relatively low, still, “the more Actos is accumulated into your system, the higher the risk,” said Azoulay.

Decisions about its use should be made according to the individual patient, said Dr. Robert Courgi, an endocrinologist with Northwell Health’s Southside Hospital in Bay Shore, N.Y.

Last year we wrote about Takeda Pharmaceuticals, the maker of Actos, agreeing to pay up to $2.4 billion to settle U.S. lawsuits that claimed the drug maker failed to inform patients of the risk of bladder cancer associated with Actos.

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