PMID- 38036054
OWN - NLM
STAT- MEDLINE
DCOM- 20240216
LR  - 20240216
IS  - 1878-1780 (Electronic)
IS  - 1262-3636 (Linking)
VI  - 50
IP  - 1
DP  - 2024 Jan
TI  - Effects of SGLT2 inhibitors on clinical cancer survival in patients with type 2 
      diabetes.
PG  - 101500
LID - S1262-3636(23)00082-4 [pii]
LID - 10.1016/j.diabet.2023.101500 [doi]
AB  - PURPOSE: According to the preclinical data, sodium-glucose cotransporter 2 
      (SGLT2) inhibitors (SGLT2is) may exert anticancer effects. Here, we clarified the 
      cancer-specific mortality (primary outcome) and all-cause mortality (secondary 
      outcome) of SGLT2is and their dose-dependency in patients with cancer undergoing 
      standard curative treatments. METHODS: We analyzed data from patients with type 2 
      diabetes mellitus (T2DM) diagnosed with cancer between January 1, 2016, and 
      December 31, 2018, enrolled from the Taiwan Cancer Registry database. 
      Kaplan-Meier method was used to estimate all-cause mortality and cancer-specific 
      mortality, comparing survival curves between SGLT2i users and nonusers using the 
      stratified log-rank test. Cox proportional hazards regression was conducted to 
      identify independent predictors for all-cause and cancer-specific mortality among 
      the covariates. RESULTS: We performed 1:2 propensity score matching of our data, 
      which yielded a final cohort of 50,133 patients with cancer; of them, 16,711 and 
      33,422 were in the SGLT2i user and nonuser groups, respectively. The adjusted 
      hazard ratio (aHR) for cancer-specific and all-cause mortality in SGLT2i users 
      compared with nonusers was 0.21 (95 % confidence interval [CI]: 0.20-0.22) and 
      0.22 (95 % CI: 0.21-0.23). We divided the patients into four subgroups stratified 
      by quartiles (Q) of cumulative defined daily doses per year (cDDDs), and 
      all-cause and cancer-specific mortality was noted to significantly decrease with 
      increases in dosage (from Q1 to Q4 cDDDs) in SGLT2i users compared with in 
      nonusers (P < 0.001). CONCLUSION: SGLT2is increase overall survival and 
      cancer-specific survival in patients with cancer in a dose-dependent manner.
CI  - Copyright (c) 2023 Elsevier Masson SAS. All rights reserved.
FAU - Huang, Yen-Min
AU  - Huang YM
AD  - Division of Hematology and Oncology, Department of Internal Medicine, Hemophilia 
      and Thrombosis Treatment Center, Chang Gung Memorial Hospital at Keelung, 
      Keelung, Taiwan; Division of Hematology and Oncology, Department of Internal 
      Medicine, Lotung Poh-Ai Hospital, Yilan, Taiwan.
FAU - Chen, Wan-Ming
AU  - Chen WM
AD  - Graduate Institute of Business Administration, College of Management, Fu Jen 
      Catholic University, Taipei, Taiwan; Artificial Intelligence Development Center, 
      Fu Jen Catholic University, Taipei, Taiwan.
FAU - Jao, An-Tzu
AU  - Jao AT
AD  - Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, 
      Taiwan.
FAU - Chen, Mingchih
AU  - Chen M
AD  - Graduate Institute of Business Administration, College of Management, Fu Jen 
      Catholic University, Taipei, Taiwan.
FAU - Shia, Ben-Chang
AU  - Shia BC
AD  - Graduate Institute of Business Administration, College of Management, Fu Jen 
      Catholic University, Taipei, Taiwan; Artificial Intelligence Development Center, 
      Fu Jen Catholic University, Taipei, Taiwan.
FAU - Wu, Szu-Yuan
AU  - Wu SY
AD  - Graduate Institute of Business Administration, College of Management, Fu Jen 
      Catholic University, Taipei, Taiwan; Artificial Intelligence Development Center, 
      Fu Jen Catholic University, Taipei, Taiwan; Big Data Center, Lo-Hsu Medical 
      Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan; Department of Food Nutrition 
      and Health Biotechnology, College of Medical and Health Science, Asia University, 
      Taichung, Taiwan; Division of Radiation Oncology, Lo-Hsu Medical Foundation, 
      Lotung Poh-Ai Hospital, Yilan, Taiwan; Department of Healthcare Administration, 
      College of Medical and Health Science, Asia University, Taichung, Taiwan; Centers 
      for Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical 
      University, Taipei, Taiwan; Department of Management, College of Management, Fo 
      Guang University, Yilan, Taiwan. Electronic address: szuyuanwu5399@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20231128
PL  - France
TA  - Diabetes Metab
JT  - Diabetes & metabolism
JID - 9607599
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/diagnosis
MH  - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
MH  - Taiwan/epidemiology
MH  - Retrospective Studies
MH  - Hypoglycemic Agents/therapeutic use
MH  - *Neoplasms/complications/drug therapy
OTO - NOTNLM
OT  - All-cause mortality
OT  - Cancer death
OT  - Dose dependent
OT  - SGLT2 inhibitor
OT  - T2DM
COIS- Declaration of Competing Interest The authors have no potential conflicts of 
      interest to declare. The data sets supporting the study conclusions are included 
      within the manuscript.
EDAT- 2023/12/01 00:43
MHDA- 2024/02/16 06:42
CRDT- 2023/11/30 21:54
PHST- 2023/02/13 00:00 [received]
PHST- 2023/11/06 00:00 [revised]
PHST- 2023/11/23 00:00 [accepted]
PHST- 2024/02/16 06:42 [medline]
PHST- 2023/12/01 00:43 [pubmed]
PHST- 2023/11/30 21:54 [entrez]
AID - S1262-3636(23)00082-4 [pii]
AID - 10.1016/j.diabet.2023.101500 [doi]
PST - ppublish
SO  - Diabetes Metab. 2024 Jan;50(1):101500. doi: 10.1016/j.diabet.2023.101500. Epub 
      2023 Nov 28.