The association of sodium-glucose cotransporter 2 inhibitors with cancer: An overview of quantitative systematic reviews.
SGLT2 inhibitors
adverse events
cancer
overview of reviews
type 2 diabetes
umbrella reviews
Journal
Endocrinology, diabetes & metabolism
ISSN: 2398-9238
Titre abrégé: Endocrinol Diabetes Metab
Pays: England
ID NLM: 101732442
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
17
02
2020
revised:
13
04
2020
accepted:
19
04
2020
entrez:
25
7
2020
pubmed:
25
7
2020
medline:
25
7
2020
Statut:
epublish
Résumé
To summarize reported cancer events associated with SGLT-2 inhibitors used in patients with type 2 diabetes mellitus, as well as assess the quality of included reviews. In May 2019, we searched PubMed, Embase and the Cochrane Library for quantitative systematic reviews assessing the safety of SGLT-2 inhibitors. Data were abstracted using a standardized form, and methodological quality was assessed using the AMSTAR 2 tool. Main outcome measures included total cancer events and specific cancers such as breast cancer, bladder cancer, gastrointestinal cancer, prostate cancer, respiratory cancer, renal cancer and skin cancer. Pooled treatment effects from included reviews were summarized for SGLT-2 inhibitors as a class and for individual SGLT-2 inhibitors commonly used worldwide (canagliflozin, dapagliflozin and empagliflozin). We screened 1248 unique citations, of which eight quantitative systematic reviews meta-analysed results from studies reporting the association between an SGLT-2 inhibitor and any cancer. Only one review was rated as high quality according to AMSTAR 2 assessment. In total, data from 170 cancer-related point estimates (PE) were reported. As a class, SGLT-2 inhibitors were not associated with an increased risk of any cancer event versus placebo and active comparators. Most point estimates (7/143) were nonsignificant for individual cancers except for two associations. Empagliflozin was associated with an increased risk of bladder cancer versus placebo and active comparators in two reviews, while canagliflozin appeared protective for gastrointestinal cancer versus placebo and active comparators in one review. It appears that SGLT-2 inhibitors are not associated with an increased risk of total cancer or specific cancers in patients with type 2 diabetes. However, higher quality evidence is needed to derive confident conclusions.
Identifiants
pubmed: 32704566
doi: 10.1002/edm2.145
pii: EDM2145
pmc: PMC7375059
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
e00145Informations de copyright
© 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
Déclaration de conflit d'intérêts
None of us have any financial arrangements or any potential conflicts of interest to disclose with regard to the products in this manuscript.
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