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Associations of SGLT2i with Cardiorenal Outcomes Among Diabetics with Prostate Cancer on Hormone Therapy

Efstratios Koutroumpakis1, Rushin Patel2, Sumanth Khadke3

  • 1Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1451, Houston, TX, 77030, USA. EKoutroumpakis@mdanderson.org.

Cardiovascular Drugs and Therapy
|November 11, 2024
PubMed
Abstract

Insights

Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) significantly reduced adverse cardiovascular and renal outcomes in diabetic prostate cancer patients on hormone therapy (HT). This suggests SGLT2i can mitigate risks associated with HT in this population.

Area of Science:

  • Cardiology
  • Endocrinology
  • Oncology

Background:

  • Hormone therapy (HT) for prostate cancer is linked to cardiovascular disease (CVD) and type II diabetes mellitus (T2DM).
  • Previous studies indicate associations between prostate cancer, T2DM, and CVD in patients undergoing HT.

Purpose of the Study:

  • To evaluate the role of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in preventing adverse cardiovascular and renal outcomes.
  • To assess the impact of SGLT2i on T2DM patients with prostate cancer receiving HT.

Main Methods:

  • Retrospective cohort study using the TriNetX research network (August 2013-August 2021).
  • Included patients aged ≥18 with T2DM and prostate cancer on HT.
  • Compared outcomes between patients treated with SGLT2i versus alternative antidiabetic therapies after propensity score matching.

Main Results:

  • SGLT2i use was associated with a significantly lower incidence of the primary composite outcome (all-cause mortality, heart failure, myocardial infarction, peripheral artery disease) (16.1% vs 26.3%).
  • SGLT2i demonstrated significant reductions in heart failure, renal replacement therapy, and all-cause mortality.
  • Reduced odds of atrial fibrillation/flutter, cardiac arrest, and hospitalizations were observed with SGLT2i.

Conclusions:

  • SGLT2 inhibitors are associated with improved cardiovascular, renal, and mortality outcomes in diabetic prostate cancer patients on hormone therapy.
  • Findings support a therapeutic link between HT and CVD in prostate cancer patients.
  • SGLT2i may offer a protective benefit against adverse events in this high-risk population.
Keywords:
Cardiovascular outcomesHormone therapyProstate cancerSGLT2 inhibitorsType II diabetes mellitus

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