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Impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors on hematologic malignancy risk: Insights from Japanese

Takehiro Kawashiri1, Naru Yamamoto2, Masaki Fujiwara3

  • 1Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan.

Journal of the National Cancer Institute
|February 15, 2026
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors may reduce the risk of hematologic malignancies in patients with diabetes. This large-scale study found a lower incidence of these cancers in SGLT2 inhibitor users.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Hematologic malignancies pose significant health risks with no established preventive strategies.
  • Emerging research suggests sodium-glucose cotransporter 2 (SGLT2) inhibitors possess cancer-suppressive qualities.
  • This study explores the potential of SGLT2 inhibitors in preventing hematologic cancers among diabetic patients.

Purpose of the Study:

  • To investigate the association between SGLT2 inhibitor use and the risk of developing hematologic malignancies.
  • To analyze the impact of SGLT2 inhibitors on specific hematologic cancers, including lymphoma and leukemia.
  • To leverage a large-scale patient database for robust epidemiological analysis.

Main Methods:

  • Utilized the JMDC Payer database (2005-2023) for patients with diabetes.
  • Categorized patients into SGLT2 inhibitor (158,877) and non-SGLT2 inhibitor (118,678) groups.
  • Employed propensity score matching to create comparable cohorts (102,478 per group) and analyzed time to malignancy endpoints.

Main Results:

  • SGLT2 inhibitor use was linked to a significantly lower incidence of overall hematologic malignancies (HR=0.73).
  • A reduced risk was observed for lymphoma (HR=0.71) and lymphocytic leukemia (HR=0.44) in the SGLT2 inhibitor group.
  • While leukemia risk showed no clear difference, acute myeloid leukemia (AML) incidence was notably lower (HR=0.34).

Conclusions:

  • SGLT2 inhibitor therapy may be associated with a decreased risk of hematologic malignancies in diabetic adults.
  • The findings suggest a potential role for SGLT2 inhibitors in cancer prevention strategies.
  • Further research is warranted to confirm these associations and elucidate underlying mechanisms.

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