Lin Tsung-Kun, Wang Wei-Yao, Yang Tsung-Yuan, Jong Gwo-Ping
Department of Pharmacy, Tri-Service General Hospital, Taipei 114202, Taiwan.
School of Pharmacy, National Defense Medical Center, Taipei 114201, Taiwan.
Cancers (Basel). 2024 Jun 5;16(11):2145. doi: 10.3390/cancers16112145.
(1) Background: Recently, sodium-glucose cotransporter-2 inhibitors (SGLT2Is) have been reported to significantly reduce renal cell carcinoma (RCC) risk. However, the effect between individual SGLT2Is on RCC incidence in patients with type 2 diabetes (T2D) or heart failure is unclear. We conducted an observational analysis to explore type disparity in the prescription of SGLT2Is on RCC risk. (2) Methods: A nationwide retrospective cohort study using the Health and Welfare Data Science Center database (2016-2021) was conducted. Patients aged ≥40 years who took SGLT2Is were designated as the SGLT2I group, whereas propensity score 1:1-matched randomly selected patients without SGLT2Is were assigned to the non-SGLT2I group. The primary outcome was the risk of incident RCC between individual SGLT2Is. Multiple Cox regression modeling was conducted to analyze the association between individual SGLT2I use and RCC risk. (3) Results: After a 5.5-year follow-up, SGLT2I use was associated with a significantly lower risk of incident RCC (hazard: 0.62; 95% confidence interval [CI]: 0.44-0.89). Compared with non-users and after adjusting for the index year, sex, age, comorbidities, concurrent medication, and the risk of developing RCC, the hazard ratios of dapagliflozin, canagliflozin, and empagliflozin were 0.66 (95% CI: 0.53-0.83), 0.84 (95% CI: 0.46-1.30), and 0.71 (95% CI: 0.56-0.90), respectively. (4) Conclusions: Our data show a type-based effect of SGLT2Is on RCC risk. The type-based effect of SGLT2Is should be further studied for better clinical management information and for reducing RCC incidence in patients with T2D.
（1）背景：最近，据报道钠-葡萄糖协同转运蛋白2抑制剂（SGLT2Is）可显著降低肾细胞癌（RCC）风险。然而，个体SGLT2Is对2型糖尿病（T2D）或心力衰竭患者RCC发病率的影响尚不清楚。我们进行了一项观察性分析，以探讨SGLT2Is处方类型对RCC风险的差异。（2）方法：利用健康与福利数据科学中心数据库（2016 - 2021年）开展了一项全国性回顾性队列研究。服用SGLT2Is的年龄≥40岁患者被指定为SGLT2I组，而倾向评分1:1匹配的随机选择的未服用SGLT2Is患者被分配到非SGLT2I组。主要结局是个体SGLT2Is之间发生RCC的风险。进行多因素Cox回归建模以分析个体使用SGLT2I与RCC风险之间的关联。（3）结果：经过5.5年的随访，使用SGLT2Is与显著降低RCC发病风险相关（风险比：0.62；95%置信区间[CI]：0.44 - 0.89）。与未使用者相比，并在调整索引年份、性别、年龄、合并症、同时用药情况以及发生RCC的风险后，达格列净、卡格列净和恩格列净的风险比分别为0.66（95%CI：0.53 - 0.83）、0.84（95%CI：0.46 - 1.30）和0.71（95%CI：0.56 - 0.90）。（4）结论：我们的数据显示SGLT2Is对RCC风险存在基于药物类型的效应。SGLT2Is基于药物类型的效应应进一步研究，以获取更好的临床管理信息并降低T2D患者的RCC发病率。
