Sodium-glucose cotransporter-2 inhibitors improve clinical outcomes in patients with type 2 diabetes mellitus undergoing anthracycline-containing chemotherapy: an emulated target trial using nationwide cohort data in South Korea

Novel hypoglycemic agents, sodium-glucose cotransporter 2 inhibitors (SGLT2i), have shown protective effects against anthracycline (AC)-induced cardiotoxicity and exhibit partial anticancer effects in animal models. However, clinical evidence for this is scarce. This study aimed to evaluate whether...

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Bibliographic Details
Published in:Scientific reports 2023-12, Vol.13 (1), p.21756-21756, Article 21756
Main Authors: Hwang, Hui-Jeong, Kim, Minji, Jun, Ji Eun, Yon, Dong Keon
Format: Article
Language:English
Subjects:
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Animal models
Anthracycline
Cardiotoxicity
Cerebral infarction
Chemotherapy
Clinical outcomes
Congestive heart failure
Diabetes
Diabetes mellitus (non-insulin dependent)
Humanities and Social Sciences
Hypoglycemic agents
Ischemia
multidisciplinary
Myocardial infarction
Science
Science (multidisciplinary)
Sodium
Sodium-glucose cotransporter
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Summary:Novel hypoglycemic agents, sodium-glucose cotransporter 2 inhibitors (SGLT2i), have shown protective effects against anthracycline (AC)-induced cardiotoxicity and exhibit partial anticancer effects in animal models. However, clinical evidence for this is scarce. This study aimed to evaluate whether SGLT2i improve the clinical outcomes of patients with type 2 diabetes mellitus (T2DM) undergoing AC-containing chemotherapy. A total of 81,572 patients who underwent AC chemotherapy between 2014 and 2021 were recruited from a nationwide Korean cohort. Patients were classified into three groups: patients with T2DM taking SGLT2i (n = 780) and other hypoglycemic agents excluding SGLT2i (non-SGLT2i; n = 3,455) during AC chemotherapy, and the non-DM group (n = 77,337). The clinical outcome was a composite of heart failure hospitalization, acute myocardial infarction, ischemic stroke, and death. After propensity score matching, 779 SGLT2i users were compared with 7800 non-DM patients and 2,337 non-SGLT2i users. The SGLT2i group had better composite outcomes compared with the non-DM group (adjusted hazard ratio [HR] = 0.35, 95% confidence interval [95% CI] = 0.25–0.51) and compared with the non-SGLT2i group (adjusted HR = 0.47, 95% CI = 0.32–0.69). In conclusion, SGLT2i may contribute to improving clinical outcomes in patients with T2DM undergoing AC-containing chemotherapy, through an emulated target trial using Korean nationwide cohort data.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-023-48678-1