Comparisons of the risks of new-onset prostate cancer in type 2 diabetes mellitus between SGLT2I and DPP4I users: A population-based cohort study

Aug 25, 2024Diabetes & metabolism

New prostate cancer risk in type 2 diabetes patients using SGLT2 inhibitors versus DPP4 inhibitors

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Abstract

Among 42,129 male patients with type-2 diabetes, SGLT2 inhibitors were associated with lower risks of new-onset prostate cancer compared to DPP4 inhibitors.

In the matched cohort, SGLT2I users had 60 new cases of prostate cancer, while DPP4I users had 102.
The hazard ratio for prostate cancer risk was 0.45, indicating a significant reduction in risk for SGLT2I users.
Follow-up duration averaged 5.61 years for the study participants.
Subgroup analyses found no significant interactions between SGLT2I use and factors such as age, hypertension, heart failure, or GLP-1 receptor agonists.
Sensitivity analyses confirmed the consistency of the findings.

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BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2I) have been suggested to reduce new-onset cancer amongst type-2 diabetes mellitus (T2DM) patients. This study aims to compare the risks of prostate cancer between SGLT2I and dipeptidyl peptidase-4 inhibitors (DPP4I) amongst T2DM patients.

DESIGN, SETTING AND PARTICIPANTS: This was a retrospective population-based cohort study of prospectively recorded data on male patients with T2DM who were prescribed either SGLT2I or DPP4I between 1January 2015 and 31December 2020 from Hong Kong. st st

METHODS: The primary outcome was new-onset prostate cancer. The secondary outcomes included cancer-related mortality and all-cause mortality. Propensity score matching (1:1 ratio) using the nearest neighbor search was performed and multivariable Cox regression was applied. A three-arm analysis including the glucagon-like peptide-1 receptor agonist (GLP1a) cohort was conducted.

RESULTS: This study included 42129 male T2DM patients (median age: 61.0 years old [SD: 12.2]; SGLT2I: n = 17,120; DPP4I: n = 25,009). In the propensity score matched cohort, the number of prostate cancers was significantly lower in SGLT2I users (n = 60) than in DPP4I (n = 102). Over a follow-up duration of 5.61 years, SGLT2I was associated with lower prostate cancer risks (HR: 0.45; 95% CI: 0.30-0.70) than DPP4I after adjustments. The subgroup analyses showed that the interactions between SGLT2I and age, hypertension, heart failure, and GLP-1a were not statistically significant. The result remained consistent in the sensitivity analysis.

CONCLUSION: The study demonstrated SGLT2I was associated with lower risks of new-onset prostate cancer after propensity score matching and adjustments compared to DPP4I amongst T2DM patients.

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Comparisons of the risks of new-onset prostate cancer in type 2 diabetes mellitus between SGLT2I and DPP4I users: A population-based cohort study

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