(86) Sodium-Glucose Cotransporter-2 Inhibitors and The Risk of Lung Cancer Among Patients with Type 2 Diabetes

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 760

Presenting Author(s)

Samantha B. Shapiro, MSc, BSc
– McGill University, McGill University, Montreal, Quebec, Canada

Co-Author(s)

Hui Yin, MSc
– The Lady Davis Research Institute, Centre for Clinical Epidemiology, Jewish General Hospital, QC, Canada, QC, Canada
Oriana Hoi Yun Yu, MD, MSc
– Assistant Professor, McGill University, Montreal, QC, Canada
Laurent Azoulay, PhD
– Associate Professor, McGill University, Montreal, Quebec, Canada, QC, Canada

Background: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have various clinical benefits in patients with type 2 diabetes. Given the increased expression of SGLT-2 in premalignant lesions and adenocarcinomas of the lung, it has been suggested that SGLT-2 inhibitors may have a role in the prevention and treatment of lung cancer. To date, this has not been assessed in a real-world setting.

Objectives: The objective of this study was to determine whether the use of SGLT-2 inhibitors, when compared with dipeptidyl peptidase 4 (DPP-4) inhibitors, is associated with a decreased risk of incident lung cancers among patients with type 2 diabetes.

Methods: We used the United Kingdom Clinical Practice Research Datalink to identify patients with type 2 diabetes who were newly prescribed SGLT-2 inhibitors or DPP-4 inhibitors (a clinically relevant comparator not previously associated with lung cancer) between 1 January 2013 and 31 December 2019. All patients were followed with a six-month lag period from the date of their first prescription until an incident diagnosis of lung cancer. Patients were censored at death from any cause, end of registration with the general practice, or end of the study period (30 June 2020). Cox proportional hazards models were fitted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident lung cancer, comparing SGLT-2 inhibitors with DPP-4 inhibitors. Propensity score fine stratification weighting was used to adjust for confounding.

Results: The cohort included 47,517 new users of SGLT-2 inhibitors and 129,807 new users of DPP-4 inhibitors. After a median follow-up of 2.6 years, SGLT-2 inhibitor use was not associated with a decreased risk of lung cancer when compared with DPP-4 inhibitors (0.92 vs. 1.37 cases per 1000 person-years, respectively; HR: 1.08, 95% CI: 0.78–1.48). There was no evidence of a duration-response relation, effect modification by smoking, or different effects by drug formulation. Findings remained consistent in several sensitivity analyses.

Conclusions: In this large cohort study, the use of SGLT-2 inhibitors was not associated with a short-term decreased risk of lung cancer. Future studies with extended follow-up periods will be needed to confirm these findings.