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Sodium-glucose co-transporter-2 (SGLT-2) inhibitors and cancer: A meta-analysis of randomized controlled trials

Ilaria Dicembrini1, Besmir Nreu1, Edoardo Mannucci1

  • 1Department of Diabetology, Careggi Teaching Hospital, University of Florence, Florence, Italy.

Diabetes, Obesity & Metabolism
|April 12, 2019
PubMed
Abstract

Insights

Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) do not increase the overall incidence of malignancies or specific cancers like bladder cancer. This meta-analysis of randomized trials found no detrimental effect of SGLT-2is on cancer risk.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Some studies suggested a potential increased risk of bladder cancer with SGLT-2 inhibitors, particularly empagliflozin.
  • This prompted an investigation into the overall and specific cancer incidence associated with SGLT-2 inhibitor use.

Purpose of the Study:

  • To conduct a meta-analysis of randomized trials to assess the effect of SGLT-2 inhibitors (SGLT-2is) on the overall incidence of malignancies.
  • To evaluate the impact of SGLT-2is on various site-specific cancers, including bladder cancer.

Main Methods:

  • A systematic search of Medline and Embase was performed for randomized trials of SGLT-2is (canagliflozin, dapagliflozin, empagliflozin, etc.) published up to December 1, 2018.
  • Trials with a duration exceeding 52 weeks, comparing SGLT-2is to placebo or active comparators, were included. Outcomes included all cancer types and site-specific cancers.
  • Mantel-Haenszel odds ratios (MH-OR) with 95% Confidence Intervals (CI) were calculated.

Main Results:

  • Twenty-seven trials with 27,944 patients in the SGLT-2 inhibitor group and 20,441 in the comparator group met the inclusion criteria.
  • No significant difference in the incidence of all malignancies was observed between SGLT-2i and comparator groups (MH-OR 0.98 [0.77-1.24]).
  • The incidence of bladder cancer and other specific cancer types was not significantly increased with SGLT-2i treatment.

Conclusions:

  • Current data from randomized trials do not indicate an increased risk of malignancies with SGLT-2 inhibitor use.
  • SGLT-2 inhibitors do not appear to have a detrimental effect on the incidence of bladder cancer or other cancers.
Keywords:
SGLT-2 inhibitorsmalignanciesmeta-analysistype 2 diabetes

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