Sodium-glucose co-transporter 2 inhibitors and risk of early breast cancer among women with type 2 diabetes
Abstract
Background: Sodium-glucose co-transporter 2 (SGLT-2) inhibitors are the newest class of antidiabetic drugs and have been shown to have cardiovascular benefits. However, numerical imbalances in breast cancer events were observed with certain SGLT-2 inhibitors (i.e., dapagliflozin) in premarketing trials, all occurring within one year of randomization. While this may have been a chance finding, it remains unclear whether use of SGLT-2 inhibitors, either as a class or by individual molecule, is associated with an early increased risk of breast cancer.Objective: The objective of this thesis was to determine whether the use of SGLT-2 inhibitors is associated with an early increased risk of breast cancer among female patients with type 2 diabetes.Methods: We used the United Kingdom Clinical Practice Research Datalink to identify a cohort of female patients newly treated with either a SGLT-2 inhibitor or a dipeptidyl peptidase 4 (DPP-4) inhibitor between January 1, 2013 and June 30, 2018, with follow-up until December 31, 2018. Cox proportional hazards models were used to estimate hazard ratios and corresponding 95% confidence intervals of breast cancer incidence, comparing new users of SGLT-2 inhibitors with new users of DPP-4 inhibitors using both intention-to-treat and as-treated approaches. The models were weighted using propensity score fine stratification.Results: This thesis study included a total of 9,938 new users of SGLT-2 inhibitors and 36,631 new users of DPP-4…
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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.
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