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SGLT2 Inhibitor Use and Risk of Breast Cancer Among Adult Women with Type 2 Diabetes

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Abstract

Introduction

Sodium–glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antihyperglycemic agents, with the potential to inhibit breast cancer development. However, the association between SGLT2 inhibitors and risk of breast cancer in human studies is unclear.

Objective

The aim of our study is to use a large national claims database to assess the association between SGLT2 inhibitor use and risk of breast cancer.

Methods

We considered a study population of 158,483 adult women with type 2 diabetes who newly initiated SGLT2 inhibitors or dipeptidyl peptidase 4 (DPP4) inhibitors using Optum’s deidentified Clinformatics Data Mart Database between 1 January 2013 and 31 March 2022. The association between SGLT2 inhibitor use and risk of breast cancer was examined using Cox proportional hazard models stratified by age in the overall sample and in a subsample based on propensity score and medication initiation time matching. The effect of medication use duration was explored.

Results

With an average follow-up of 2.2 years, 2154 breast cancer cases were identified. There was no significant association between SGLT2 inhibitor use and the risk of breast cancer in overall sample (HR = 0.96; 95% CI 0.87, 1.06), in women younger than 51 years old (HR = 0.88; 95% CI 0.59, 1.32), or in women aged 51 years or older (HR = 0.95; 95% CI 0.86, 1.04). The results remained nonsignificant using matching, medication use duration, and sensitivity analyses.

Conclusion

Our findings suggest SGLT2 inhibitors use was not associated with breast cancer risk compared with DPP4 inhibitors use. Studies with longer follow-up and better adjustments are needed to confirm the finding.

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Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA

    Fengge Wang, Nianjun Liu, Aurelian Bidulescu & Juhua Luo

  2. Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA

    Michael Hendryx

  3. School of Medicine-Bloomington, Indiana University, Bloomington, IN, USA

    Anirban K. Mitra

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Corresponding author

Correspondence to Fengge Wang.

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Funding

Not applicable.

Conflicts of Interest

The authors declare that there are no competing interests.

Availability of Data and Material

The data supporting this study's findings are not publicly available due to reasons of sensitivity but can be accessed from Optum on reasonable request. Optum service website: https://www.optum.com/business/insights/life-sciences/page.hub.contact-lifesciences.html.

Ethics Approval

This study was approved by the Indiana University institutional review board (protocol number: 21486).

Consent for Participate

Consent was waived by the institutional review board due to the utilization of deidentified data.

Consent for Publication

Not applicable.

Code Availability

Available on reasonable request from the corresponding author.

Author Contributions

FW, JL, and MH contributed to the design of the study. FW performed the analysis. The first draft of the manuscript was written by FW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Wang, F., Hendryx, M., Liu, N. et al. SGLT2 Inhibitor Use and Risk of Breast Cancer Among Adult Women with Type 2 Diabetes. Drug Saf 47, 125–133 (2024). https://doi.org/10.1007/s40264-023-01373-6

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