Tanaka Yuki, Yokoyama Satoshi, Nakagawa Chihiro, Uno Takaya, Hosomi Kouichi
Int J Clin Pharmacol Ther. 2023 Nov;61(11):492-502. doi: 10.5414/CP204465.
Pancreatic cancer-related mortality is increasing worldwide, and prevention methods and effective novel therapies are required. In pancreatic cancer, sodium-glucose cotransporters (SGLT) are involved in glucose uptake. This study aimed to clarify the association between SGLT2 inhibitors and pancreatic cancer development.
A nested case-control study was conducted using the JMDC administrative claims database (January 2005 to June 2020). Patients newly diagnosed with type 2 diabetes mellitus (T2DM) were included, and cases were defined as patients who developed pancreatic cancer. Patients with outcomes were randomly matched to a maximum of 20 controls according to age (± 5 years), sex, and calendar date (month and year) of the first T2DM diagnosis through risk set sampling.
Of the 181,107 T2DM patients, 363 cases and 7,043 controls were selected with 14 and 457 patients prescribed SGLT2 inhibitors, respectively. Cumulative administration of SGLT2 inhibitors for > 180 days was significantly inversely associated with the development of pancreatic cancer (adjusted odds ratio: 0.58, 95% confidence interval: 0.31 - 0.99).
SGLT2 inhibitors may reduce the risk of developing pancreatic cancer in T2DM patients. The number of patients over 65 years of age was small in this study due to the nature of the data source. Further studies with larger sample sizes including older patients are needed.
全球范围内胰腺癌相关死亡率正在上升，需要预防方法和有效的新型治疗手段。在胰腺癌中，钠-葡萄糖协同转运蛋白（SGLT）参与葡萄糖摄取。本研究旨在阐明SGLT2抑制剂与胰腺癌发生之间的关联。
利用JMDC行政索赔数据库（2005年1月至2020年6月）进行巢式病例对照研究。纳入新诊断为2型糖尿病（T2DM）的患者，病例定义为发生胰腺癌的患者。通过风险集抽样，根据年龄（±5岁）、性别和首次T2DM诊断的日历日期（月和年），将有结局的患者随机匹配至多20名对照。
在181,107例T2DM患者中，选择了363例病例和7,043名对照，分别有14例和457例患者使用了SGLT2抑制剂。SGLT2抑制剂累计使用超过180天与胰腺癌的发生显著负相关（调整后的比值比：0.58，95%置信区间：0.31 - 0.99）。
SGLT2抑制剂可能降低T2DM患者发生胰腺癌的风险。由于数据来源的性质，本研究中65岁以上患者数量较少。需要开展包括老年患者在内的更大样本量的进一步研究。
