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Incretin-Based Drugs and the Incidence of Prostate Cancer Among Patients With Type 2 Diabetes

Sally Lu1,2, Hui Yin2, Oriana H Y Yu2,3

  • 1From the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.

Epidemiology (Cambridge, Mass.)
|April 8, 2022
PubMed
Abstract

Insights

Glucagon-like peptide 1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors may lower prostate cancer risk in type 2 diabetes patients. This real-world evidence supports their potential chemopreventive effects compared to sulfonylureas.

Area of Science:

  • Endocrinology
  • Oncology
  • Pharmacology

Background:

  • Limited real-world data exists on the chemopreventive effects of GLP-1 receptor agonists and DPP-4 inhibitors on prostate cancer.
  • Previous studies suggest potential chemopreventive properties of these drug classes in prostate cancer cells.

Purpose of the Study:

  • To investigate the association between the use of GLP-1 receptor agonists and prostate cancer risk.
  • To evaluate the association between the use of DPP-4 inhibitors and prostate cancer risk.
  • To compare these risks against sulfonylurea use in patients with type 2 diabetes.

Main Methods:

  • Two new-user, active-comparator cohorts were established using UK Clinical Practice Research Datalink (2007-2019).
  • Cohort 1: GLP-1 receptor agonists (n=5,063) vs. sulfonylureas (n=112,955).
  • Cohort 2: DPP-4 inhibitors (n=53,529) vs. sulfonylureas (n=114,417).
  • Propensity score fine stratification and Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs).

Main Results:

  • GLP-1 receptor agonists were associated with a decreased risk of prostate cancer compared to sulfonylureas (HR=0.65; 95% CI=0.43-0.99).
  • DPP-4 inhibitors were also associated with a decreased risk of prostate cancer compared to sulfonylureas (HR=0.90; 95% CI=0.81-1.00).

Conclusions:

  • Findings suggest that GLP-1 receptor agonists may reduce prostate cancer risk in type 2 diabetes patients.
  • DPP-4 inhibitors may also be associated with a reduced risk of prostate cancer.
  • These results support the hypothesis of a chemopreventive role for these drug classes against prostate cancer.

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