| アブストラクト | OBJECTIVE: To determine whether sodium-glucose cotransporter 2 (SGLT2) inhibitors, compared with glucagon-like peptide 1 receptor agonists (GLP-1RAs) or dipeptidyl peptidase 4 (DPP-4) inhibitors, are associated with an increased risk of early bladder cancer events. RESEARCH DESIGN AND METHODS: We conducted a multisite, population-based, new-user, active comparator cohort study using the U.K. Clinical Practice Research Datalink, Medicare fee-for-service, Optum's de-identifed Clinformatics Data Mart Database (CDM), and MarketScan Health databases from January 2013 through December 2020. We assembled two cohorts of adults with type 2 diabetes initiating 1) SGLT2 inhibitors or GLP-1RAs and 2) SGLT2 inhibitors or DPP-4 inhibitors. Cox proportional hazards models were fit to estimate hazard ratios (HRs) and 95% CIs of incident bladder cancer. The models were weighted using propensity score fine stratification. Site-specific HRs were pooled using random-effects models. RESULTS: SGLT2 inhibitor (n = 453,560) and GLP-1RA (n = 375,997) users had a median follow-up ranging from 1.5 to 2.2 years. Overall, SGLT2 inhibitors were not associated with an increased risk of bladder cancer compared with GLP-1RAs (HR 0.90, 95% CI 0.81-1.00). Similarly, when compared with DPP-4 inhibitors (n = 853,186), SGLT2 inhibitors (n = 347,059) were not associated with an increased risk of bladder cancer (HR 0.99, 95% CI 0.91-1.09) over a median follow-up ranging from 1.6 to 2.6 years. Results were consistent across sensitivity analyses. CONCLUSIONS: Contrary to previous randomized controlled trials, these findings indicate that the use of SGLT2 inhibitors is not associated with an increased risk of bladder cancer compared with GLP-1RAs or DPP-4 inhibitors. This should provide reassurance on the short-term effects of SGLT2 inhibitors on bladder cancer incidence. |
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| 投稿日 | 2022/9/29 |
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| 投稿者 | Abrahami, Devin; Tesfaye, Helen; Yin, Hui; Vine, Seanna; Hicks, Blanaid; Yu, Oriana H Y; Campeau, Lysanne; Platt, Robert W; Schneeweiss, Sebastian; Patorno, Elisabetta; Azoulay, Laurent |
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| ジャーナル名 | Diabetes care |
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| 組織名 | Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital,;Montreal, Quebec, Canada.;Department of Epidemiology, Biostatistics, and Occupational Health, McGill;University, Montreal, Quebec, Canada.;Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine,;Brigham and Women's Hospital and Harvard Medical School, Boston, MA.;Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland,;U.K.;Division of Endocrinology, Jewish General Hospital, Montreal, Quebec, Canada.;Department of Urology, Jewish General Hospital, Montreal, Quebec, Canada.;Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec,;Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/36170656/ |
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