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Risk of prostatitis in patients with type 2 diabetes mellitus: An observational retrospective cohort study of canagliflozin versus other antihyperglycemic agents using propensity score matching

Zhong Yuan, Carolyn Jeffcoat, Saberi Rana Ali, Anthony G. Sena, M. Schuemie, Patrick B. Ryan, Sergio Fonseca

PLoS ONE, 2026

657,134 participants · 2 citations

Abstract

PURPOSE: Prostatitis has been reported in patients with type 2 diabetes mellitus (T2DM) receiving antihyperglycemic agents (AHAs). This study was conducted to evaluate the risk of prostatitis with canagliflozin in response to a specific Health Authority query.

METHODS: This retrospective cohort study used data from adult male patients with T2DM who were new users of canagliflozin (target) or comparators (empagliflozin, dapagliflozin, sitagliptin, and liraglutide). Data were obtained from 8 global administrative claims databases, transformed to a Common Data Model for consistent analysis across databases. Pairwise comparisons were conducted using propensity scores to match canagliflozin users to users of each comparator at a 1:n ratio (maximum n = 100). Hazard ratios were estimated using a Cox proportional hazards model, conditioned on the matched set.

RESULTS: A total of 388,893 adult male patients with T2DM received canagliflozin across databases (mean age, 51.2-71.7 years) and were matched to 657,134 patients receiving empagliflozin, 340,539 receiving dapagliflozin, 819,047 receiving sitagliptin, and 278,684 receiving liraglutide. On-treatment incidence rates showed that prostatitis was uncommon in the canagliflozin cohort in nearly all databases (4.2-7.7 per 1000 person-years) and were similar to those of the comparator treatments. The exception was a higher crude incidence rate in the Merative MarketScan® Medicare Supplemental Database (10.1-12.1 per 1000 person-years).…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 657,134 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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