Risk of incident renal cell carcinoma in patients with type 2 diabetes on sodium-glucose co-transporter-2 inhibitor users: a population-based cohort study

Abstract

Abstract Background and aims Patients with type 2 diabetes (T2D) are at substantially higher risk for developing renal cell carcinoma (RCC) than the general population. Clinical studies have investigated the effects of sodium-glucose co-transporter-2 inhibitor (SGLT-2I) use on the development of incident RCC in patients with T2D, but the findings are inconsistent. This study aimed to examine the association between SGLT-2I use and incident RCC risk in patients with T2D. Methods We conducted a nationwide retrospective cohort study using the Taiwan Health Insurance Review and Assessment Service database (2009–2019). The primary outcome was the risk of incident RCC by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Therefore, multiple Cox regression modeling was conducted to analyze the association between SGLT-2I use and incident RCC risk in patients with T2D. Results In a cohort of 241,772 patients with T2D using SGLT-2I and 483,544 participants not using SGLT-2Is, 220 and 609 incident RCCs were recorded, respectively. There was a decreased risk of incident RCC for SGLT-2I users after adjusting for the index year, sex, age, comorbidities, and concurrent medication (adjusted HR 0.68, 95% CI 0.58–0.81) compared with non-SGLT-2I users. The sensitivity test for the propensity score 1:1-matched analyses showed similar result (adjusted HR 0.67, 95% CI 0.56–0.81). Conclusions SGLT-2I therapy may effectively decrease RCC risk in patients with T2D. More studies are needed to credibly evaluate the effects of SGLT-2I therapy on RCC prevention in patients with T2D.