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Sodium-Glucose co-Transporter-2 (SGLT-2) inhibitors and cancer: A Meta-analysis Of Randomized Controlled Trials

Ilaria Dicembrini, Besmir Nreu, Edoardo Mannucci, Matteo Monami
Diabetes, Obesity & Metabolism 2019 April 11

BACKGROUND: Concerns on the effect of SGLT-2 inhibitors (SGLT-2i) have been risen by some studies, showing an increased incidence of bladder cancer, particularly for empagliflozin. Aim of the present meta-analysis of randomized trials is the assessment of the effects of SGLT-2i on overall incidence of malignancies and on different cancer types, synthetizing the results of trials with a duration of at least one year.

METHODS: A Medline and Embase search for "Canaglifozin", "Dapaglifozin", "Empaglifozin", "Ertuglifozin", "Ipraglifozin", Tofoglifozin", or "Luseoglifozin" was performed, collecting randomized trials (duration>52 weeks) up to December 1st , 2018, comparing SGLT-2i with placebo or active comparators. The outcomes considered in the present meta-analysis were all type and several site-specific cancer (i.e. breast, pulmonary, gastrointestinal, hepatic, pancreatic, skin, prostate, and bladder). Mantel-Haenszel odds ratio with 95% Confidence Interval (MH-OR, 95% CI) was calculated for all outcomes defined above.

RESULTS: A total of 27 trials fulfilling the inclusion criteria was identified. Retrieved trials enrolled 27,744 and 20,441 patients in SGLT-2 inhibitor and comparator groups, respectively. No difference was observed in the incidence of all malignancies between patients allocated to SGLT-2i and comparators (MH-OR 0.98[0.77-1.24]. The incidence of bladder cancer, and of any other type of cancer, was not significantly increased by treatment with any SGLT-2i.

CONCLUSIONS: available data from randomized trials do not suggest any detrimental effect of SGLT-2i on the incidence of malignancies in general, or bladder cancer in particular. This article is protected by copyright. All rights reserved.


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