Sodium-glucose cotransporter 2 inhibitors versus dipeptidyl peptidase 4 inhibitors on new-onset overall cancer in type 2 diabetes mellitus: a population-based study

Abstract

AbstractBackgroundThere is much uncertainty regarding the comparative risks of cancer for T2DM patients on SGLT2I versus DPP4I.MethodsThis population-based cohort study patients included T2DM patients who were administered with either SGLT2I or DPP4I between January 1st, 2015, to December 31st, 2020 in Hong Kong.ResultsAmongst 60112 T2DM patients (mean baseline age: 62.1±12.4 years, male: 56.36%), 18167 patients were SGLT2I users and 41945 patients were DPP4I users. Multivariate cox regression analysis revealed that SGLT2I usage was associated with a decreased risk of all-cause mortality (HR:0.92; 95%CI:0.84-0.99; P=0.04), cancer-related mortality (HR:0.58; 95%CI:0.42-0.80; P≤0.001) and a 30% risk reduction of new-onset overall cancer (HR:0.70; 95%CI:0.59-0.84; P≤0.001). Dapagliflozin and ertugliflozin both demonstrated superiority in relation to new-onset cancer development, with the former demonstrating a lowered risk of breast cancer (HR:0.48; 95%CI:0.27-0.83; P=0.001).ConclusionSGLT2I was associated with lower risk of all-cause mortality, cancer-related mortality and new-onset overall cancer compared to DPP4I.