Rothman Sonny M, Yin Hui, Yu Oriana H Y, Pollak Michael, Azoulay Laurent
Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Cote Sainte-Catherine, H425.1, Montreal, Quebec, H3T 1E2, Canada.
Department of Epidemiology, and Occupational Health, McGill University, BiostatisticsMontreal, QC, H3A 1G1, Canada.
Drug Saf. 2025 May 10. doi: 10.1007/s40264-025-01551-8.
The use of incretin-based drugs may be associated with a decreased risk of endometrial cancer among women with type 2 diabetes.
Using data from the UK Clinical Practice Research Datalink and linked databases, two new-user active comparator cohorts of women with type 2 diabetes who initiated glucagon-like peptide 1 receptor agonists (GLP-1 RAs) or sulfonylureas (cohort 1) and DPP-4 inhibitors or sulfonylureas (cohort 2) were assembled. Propensity score fine stratification weighted Cox proportional hazards models were fitted to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident endometrial cancer.
Cohort 1 included 9239 new users of GLP-1 RAs and 80,086 new users of sulfonylureas. The GLP-1 RAs were not associated with a decreased risk of endometrial cancer when compared with sulfonylureas (HR: 1.11, 95% CI: 0.66-1.88). In a duration-response secondary analysis, use of GLP-1 RAs for more than two years was associated with an increased risk of endometrial cancer (HR: 2.47, 95% CI: 1.37-4.43) when compared to sulfonylureas When analysed by drug type, exenatide was associated with an elevated risk when compared to sulfonylureas (HR: 2.26, 95% CI:1.06-4.82). Cohort 2 included 42,486 new users of DPP-4 inhibitors and 79,353 new users of sulfonylureas. DPP-4 inhibitors were not associated with a decreased risk of endometrial cancer compared with sulfonylureas (HR: 1.00, 95% CI: 0.76-1.32). In a duration-response secondary analysis, use of DPP-4 inhibitors for more than two years was associated with an increased risk of endometrial cancer (HR: 1.63, 95% CI: 1.14-2.33) when compared to sulfonylureas.
In this population-based study, the use of GLP-1 RAs and DPP-4 inhibitors was not associated with a decreased risk of endometrial cancer when compared with the use of sulfonylureas among women with type 2 diabetes.
在2型糖尿病女性中，使用基于肠促胰岛素的药物可能与子宫内膜癌风险降低有关。
利用英国临床实践研究数据链和相关数据库的数据，组建了两个新用户活性对照队列，即开始使用胰高血糖素样肽1受体激动剂（GLP-1 RAs）或磺脲类药物的2型糖尿病女性队列（队列1），以及开始使用二肽基肽酶-4抑制剂（DPP-4抑制剂）或磺脲类药物的2型糖尿病女性队列（队列2）。采用倾向评分精细分层加权Cox比例风险模型来估计子宫内膜癌发病的调整风险比（HRs）和95%置信区间（CIs）。
队列1包括9239名GLP-1 RAs新用户和80,086名磺脲类药物新用户。与磺脲类药物相比，GLP-1 RAs与子宫内膜癌风险降低无关（HR：1.11，95% CI：0.66 - 1.88）。在一项时长 - 反应的二次分析中，与磺脲类药物相比，使用GLP-1 RAs超过两年与子宫内膜癌风险增加有关（HR：2.47，95% CI：1.37 - 4.43）。按药物类型分析时，与磺脲类药物相比，艾塞那肽与风险升高有关（HR：2.26，95% CI：1.06 - 4.82）。队列2包括42,486名DPP-4抑制剂新用户和79,353名磺脲类药物新用户。与磺脲类药物相比，DPP-4抑制剂与子宫内膜癌风险降低无关（HR：1.00，95% CI：0.76 - 1.32）。在一项时长 - 反应的二次分析中，与磺脲类药物相比，使用DPP-4抑制剂超过两年与子宫内膜癌风险增加有关（HR：1.63，95% CI：
