Sodium-glucose cotransporter-2 inhibitors and cancer outcomes: A systematic review and meta-analysis of randomized controlled trials.

Autor: Spiazzi BF; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Naibo RA; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Wayerbacher LF; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Piccoli GF; Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Farenzena LP; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Londero TM; Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., da Natividade GR; Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Zoldan M; Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Degobi NAH; Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Niches M; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Lopes G; Sylvester Comprehensive Cancer Center, Global Oncology Program, Miami, FL, United States., Boyko EJ; Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle WA, 98195, United States; Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States., Utzschneider KM; Research and Development, VA Puget Sound Health Care System, Seattle, WA, 98108, United States; Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle WA, 98195, United States., Colpani V; Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Gerchman F; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. Electronic address: fgerchman@hcpa.edu.br.
Jazyk: angličtina
Zdroj: Diabetes research and clinical practice [Diabetes Res Clin Pract] 2023 Apr; Vol. 198, pp. 110621. Date of Electronic Publication: 2023 Mar 13.
DOI: 10.1016/j.diabres.2023.110621
Abstrakt: Aims: Concerns regarding breast and bladder cancer risk with Sodium-glucose cotransporter-2 (SGLT2) inhibitors remain controversial and its effect on cancer mortality is unknown. We aim to evaluate the association between SGLT2 inhibitors and the risk of cancer outcomes.
Methods: We searched PubMed, Embase and CENTRAL up to June 20th, 2022, for randomized controlled trials of SGLT2 inhibitors in adults, with a minimum follow-up of 48 weeks. Researchers extracted study-level data and assessed within-study risk of bias with the RoB 2.0 tool and quality of evidence with GRADE. We performed meta-analyses summarizing the relative risks (RRs) of cancer outcomes.
Results: Seventy-six trials encompassing 116,375 participants were selected. Overall risk of bias was low. SGLT2 inhibitors did not reduce/increase the overall risk of cancer (RR, 1.03; 95% confidence interval [CI], 0.96-1.10) and cancer mortality (RR, 0.99; 95% CI, 0.85-1.16). SGLT2 inhibitors likely result in little to no difference in the risk of breast (RR, 1.01; 95% CI 0.77-1.32) and bladder cancers (RR, 0.93; 95% CI 0.71-1.21). Trial sequential analysis provided evidence that the sample size was sufficient to avoid missing alternative results.
Conclusions: SGLT2 inhibitors are not associated with an increased risk of cancer outcomes, providing reassuring data regarding previous safety concerns.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE
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