Decreased risk of renal cell carcinoma in patients with type 2 diabetes treated with sodium glucose cotransporter‐2 inhibitors

• Published in: Cancer science Vol. 115; no. 6; pp. 2059 - 2066
• Main Authors: Chiu, Chun‐Huei, Wang, Wei‐Yao, Chen, Hung‐Yi, Liao, Pei‐Lun, Jong, Gwo‐Ping, Yang, Tsung‐Yuan
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.06.2024; John Wiley and Sons Inc
• Subjects: Adult; Age; Aged; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - epidemiology; Cardiovascular disease; Cell cycle; chronic kidney disease; Chronic obstructive pulmonary disease; Codes; Comorbidity; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Epidemiology; Female; Glucose; Humans; Hypertension; Incidence; Kidney cancer; Kidney diseases; Kidney Neoplasms - drug therapy; Male; Middle Aged; Nonsteroidal anti-inflammatory drugs; Original; ORIGINAL ARTICLES; Patients; Population studies; Prescriptions; Proportional Hazards Models; Renal cell carcinoma; Retrospective Studies; Rheumatoid arthritis; Risk Factors; Sensitivity analysis; SGLT2 inhibitor; Sodium; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; type 2 DM; chronic kidney disease; renal cell carcinoma; comorbidity; type 2 DM; SGLT2 inhibitor
• ISSN: 1347-9032; 1349-7006; 1349-7006
• DOI: 10.1111/cas.16157

Patients with type 2 diabetes (T2D) are at a higher risk of developing renal cell carcinoma (RCC) than the general population. In vitro and in vivo investigations of the effects of sodium glucose cotransporter‐2 inhibitors (SGLT2I) have shown a significantly reduced risk of RCC. However, the impact of these drugs on the incidence of RCC in the human population is unclear. This study aimed to examine the association between SGLT2I use and RCC risk in patients with T2D. We undertook a nationwide retrospective cohort study using the Health and Welfare Data Science Center database (2016–2020). The primary outcome was the risk of incident RCC by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression modeling was applied to analyze the association between SGLT2I use and RCC risk in patients with T2D. In a cohort of 241,772 patients with T2D who were using SGLT2Is and 483,544 participants who were not, 220 and 609 RCC cases, respectively, were recorded. The mean follow‐up period of the study subjects was 2 years. There was a decreased risk of RCC for SGLT2I users after adjusting for the index year, sex, age, comorbidities, and concurrent medication (adjusted HR 0.68; 95% CI, 0.58–0.81). The sensitivity test for the propensity score 1:1‐matched analyses showed similar results (adjusted HR 0.67; 95% CI, 0.55–0.81). The subgroup analysis revealed consistent results for sex, age (<70 years), and comorbidity with chronic kidney disease. The present study indicates that SGLT2I therapy significantly decreases RCC risk in patients with T2D. This finding was also consistent among the sensitivity test and subgroup analysis for those with or without chronic kidney disease/hypertension. The present study indicates that sodium glucose cotransporter‐2 inhibitor therapy significantly decreases renal cell carcinoma risk in patients with type 2 diabetes. This finding was also consistent among the sensitivity test and subgroup analysis.