Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA.
Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA.
Br J Cancer. 2023 Apr;128(8):1541-1547. doi: 10.1038/s41416-023-02177-2. Epub 2023 Feb 10.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs with demonstrated renal and cardiovascular disease benefit. This study evaluates the role of SGLT2 inhibitors on the survival of non-small cell lung cancer (NSCLC) patients.
We used National Surveillance, Epidemiology and End Results (SEER)-Medicare linked data. Twenty four thousand nine hundred fifteen NSCLC patients newly diagnosed between 2014 and 2017 with pre-exiting diabetes and aged 66 years or older were included and followed to the end of 2019. Information on SGLT2 inhibitors use was extracted from the Medicare Part D file.
SGLT2 inhibitor use was associated with significantly reduced mortality risk after adjusting for potential confounders (HR = 0.68, 95% CI = 0.60-0.77) with stronger association for longer duration of use (HR = 0.54, 85% CI = 0.44-0.68). Further, we found that SGLT2 inhibitor use was associated with a significant reduced risk of mortality regardless of patients' demographic, tumour characteristics and cancer treatments.
Our large SEER-Medicare linked data study indicates that SGLT2 inhibitors use was associated with improved overall survival of NSCLC patients with pre-existing diabetes. Further studies are needed to confirm our findings and elucidate the possible mechanisms behind the association.
钠-葡萄糖共转运蛋白 2(SGLT2)抑制剂是一类新型的抗糖尿病药物,已证实具有肾脏和心血管疾病获益。本研究评估 SGLT2 抑制剂对非小细胞肺癌(NSCLC)患者生存的影响。
我们使用了国家监测、流行病学和最终结果(SEER)-医疗保险关联数据。纳入了 2014 年至 2017 年间新诊断为 NSCLC、年龄在 66 岁或以上且有既往糖尿病的 24915 例患者,并随访至 2019 年底。SGLT2 抑制剂的使用信息从医疗保险部分 D 文件中提取。
在调整了潜在混杂因素后,SGLT2 抑制剂的使用与死亡率风险显著降低相关(HR=0.68,95%CI=0.60-0.77),且使用时间越长关联越强(HR=0.54,95%CI=0.44-0.68)。此外,我们发现无论患者的人口统计学、肿瘤特征和癌症治疗如何,SGLT2 抑制剂的使用都与死亡率风险显著降低相关。
我们的大型 SEER-医疗保险关联数据研究表明,SGLT2 抑制剂的使用与患有既往糖尿病的 NSCLC 患者的总体生存率提高有关。需要进一步的研究来证实我们的发现,并阐明这种关联背后的可能机制。