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

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Oscar Hou In Chou1, Lei Lu2, Cheuk To Chung3

  • 1Division of Clinical Pharmacology, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.

Diabetes & Metabolism
|August 25, 2024
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2I) show reduced prostate cancer risk in type-2 diabetes mellitus (T2DM) patients compared to dipeptidyl peptidase-4 inhibitors (DPP4I). This finding suggests SGLT2I may offer protective benefits against cancer in this population.

Area of Science:

  • Endocrinology
  • Oncology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2I) are linked to reduced cancer incidence in type-2 diabetes mellitus (T2DM) patients.
  • A comparative analysis of prostate cancer risk between SGLT2I and dipeptidyl peptidase-4 inhibitors (DPP4I) in T2DM patients is warranted.

Purpose of the Study:

  • To compare the risk of new-onset prostate cancer in male T2DM patients treated with SGLT2I versus DPP4I.
  • To evaluate secondary outcomes including cancer-related and all-cause mortality.

Main Methods:

  • Retrospective, population-based cohort study utilizing prospectively recorded data from Hong Kong (2015-2020).
  • Inclusion of male T2DM patients prescribed either SGLT2I or DPP4I.
  • Propensity score matching (1:1) and multivariable Cox regression analysis were employed.

Main Results:

  • The study included 42,129 male T2DM patients.
  • SGLT2I users exhibited a significantly lower incidence of prostate cancer (60 cases) compared to DPP4I users (102 cases) in the propensity score matched cohort.
  • SGLT2I use was associated with a reduced risk of prostate cancer (HR: 0.45; 95% CI: 0.30-0.70) compared to DPP4I after adjustments.

Conclusions:

  • SGLT2I use is associated with a lower risk of new-onset prostate cancer in T2DM patients compared to DPP4I.
  • Results were consistent across subgroup and sensitivity analyses, indicating robustness of the findings.
Keywords:
Dipeptidyl peptidase-4 inhibitorsGlucagon-like peptide-1 receptor agonistProstateProstate cancerSodium-glucose cotransporter 2 inhibitors

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