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Sodium-glucose cotransporter 2 (SGLT2) inhibitor initiation and hepatocellular carcinoma prognosis

Michael Hendryx1, Yi Dong2,3, Jonas M Ndeke4

  • 1Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, Indiana, United States of America.

Plos One
|September 12, 2022
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors may improve survival for patients with type 2 diabetes and liver cancer. This study found SGLT2 inhibitor use was linked to a reduced risk of mortality in hepatocellular carcinoma (HCC) patients.

Area of Science:

  • Oncology
  • Pharmacology
  • Epidemiology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors are antidiabetic drugs with emerging evidence suggesting potential benefits in liver function and hepatocellular carcinoma (HCC) suppression.
  • Laboratory studies indicate SGLT2 inhibitors may inhibit HCC cell proliferation, prompting investigation into their clinical impact on HCC prognosis.

Purpose of the Study:

  • To investigate the association between the initiation of SGLT2 inhibitors and the prognosis of hepatocellular carcinoma (HCC) in a human population.
  • To test the hypothesis that SGLT2 inhibitor use improves HCC patient survival.

Main Methods:

  • Utilized the National Surveillance, Epidemiology and End Results (SEER)-Medicare linked data in the United States.
  • Included 3,185 HCC patients aged 66+ with type 2 diabetes, newly diagnosed between 2014-2017, and followed through 2019.
  • Extracted SGLT2 inhibitor initiation data from Medicare Part D files to assess its impact on HCC patient survival.

Main Results:

  • SGLT2 inhibitor initiation was significantly associated with a lower mortality risk in HCC patients (HR = 0.68, 95% CI = 0.54-0.86).
  • A stronger association with reduced mortality was observed with longer SGLT2 inhibitor use (HR = 0.60, 95% CI = 0.41-0.88).
  • Mortality risk reduction ranged from 14% to 60%, irrespective of patient demographics, tumor characteristics, or cancer treatments.

Conclusions:

  • Initiation of SGLT2 inhibitors is associated with improved overall survival in HCC patients with pre-existing type 2 diabetes.
  • Findings suggest a potential survival benefit of SGLT2 inhibitors for HCC patients.
  • Further research is warranted to confirm these findings and explore the underlying mechanisms.

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