Real-world evidence on the association of novel antidiabetic medication use with cancer risk and protective effects: a systematic review and network meta-analysis.

IF 3.4 3区医学 Q2 PHARMACOLOGY & PHARMACY

Therapeutic Advances in Drug Safety Pub Date : 2025-04-21 eCollection Date: 2025-01-01 DOI:10.1177/20420986251335214

Ahmed S Kenawy, Yi-Shao Liu, Ayobami Aiyeolemi, Godwin Okoye, Chanhyun Park

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引用次数: 0

Abstract

Background: Novel antidiabetic medications (SGLT-2 inhibitors, DPP-4 inhibitors, and GLP-1 agonists) are commonly used worldwide; however, the available research lacks definitive conclusions on their protective effects or potential risks on cancer.

Objectives: Compared to other antidiabetics, our systematic review and network meta-analysis (NMA) aims to use real-world studies to assess the potential cancer risks or protective effects of these novel antidiabetics.

Methods: We comprehensively searched PubMed, CINAHL, and Web of Science from their inception until November 30, 2023. We included observational studies examining at least one novel antidiabetics in the systematic review. The novel antidiabetics include sodium-glucose cotransporter-2 inhibitors (SGLT-2i), dipeptidyl peptidase-4 inhibitors (DPP-4i), and glucagon-like peptide-1 agonists (GLP-1a).

Design: We focused on cohort studies that provided data on cancer incidence and sample size in the NMA. Using NetMetaXL^®, the random effects model with informative priors was used in the NMA to estimate the pooled odds ratio (OR) with 95% credible intervals (CrI).

Results: The systematic review included 62 studies, of which 22 met the inclusion criteria for the NMA. SGLT-2i users had lower overall cancer risk compared to sulfonylureas (OR: 0.54; 95% CrI: 0.40-0.74, low certainty), GLP-1a (OR: 0.70; 95% CrI: 0.53-0.92, low certainty), and DPP-4i users (OR: 0.72; 95% CrI: 0.57-0.92, very low certainty). DPP-4i users also had a lower cancer risk than sulfonylureas users (OR: 0.76; 95% CrI: 0.60-0.96, low certainty). No other statistically significant ORs were found in other direct comparisons.

Conclusion: SGLT-2i users have a lower risk of developing cancers than sulfonylureas, GLP-1a, and DPP-4i users. These results may improve patient safety by guiding future clinical practice and medication choices. Future studies should investigate the mechanisms behind these observed associations.

Trial registration: This NMA was registered in PROSPERO (CRD42023469941).

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新型抗糖尿病药物使用与癌症风险和保护作用相关的真实证据：系统回顾和网络荟萃分析。

背景：新型降糖药物（SGLT-2抑制剂、DPP-4抑制剂和GLP-1激动剂）在世界范围内被广泛使用；然而，现有的研究缺乏关于它们对癌症的保护作用或潜在风险的明确结论。目的：与其他抗糖尿病药物相比，我们的系统综述和网络荟萃分析（NMA）旨在利用现实世界的研究来评估这些新型抗糖尿病药物的潜在癌症风险或保护作用。方法：我们综合检索PubMed、CINAHL和Web of Science，从它们成立到2023年11月30日。我们在系统评价中纳入了至少一种新型抗糖尿病药物的观察性研究。新型降糖药包括钠-葡萄糖共转运蛋白-2抑制剂（SGLT-2i）、二肽基肽酶-4抑制剂（DPP-4i）和胰高血糖素样肽-1激动剂（GLP-1a）。设计：我们关注的是在NMA中提供癌症发病率和样本量数据的队列研究。使用NetMetaXL®，在NMA中使用具有信息先验的随机效应模型来估计95%可信区间（CrI）的合并优势比（OR）。结果：系统评价纳入62项研究，其中22项符合NMA的纳入标准。与磺脲类药物相比，SGLT-2i使用者的总体癌症风险较低(OR: 0.54；95% CrI: 0.40-0.74，低确定性),GLP-1a (OR: 0.70；95% CrI: 0.53-0.92，低确定性)和DPP-4i用户(OR: 0.72；95% CrI: 0.57-0.92，极低确定性)。DPP-4i服用者患癌症的风险也低于磺脲类服用者(OR: 0.76；95% CrI: 0.60-0.96，低确定性)。在其他直接比较中没有发现其他具有统计学意义的or。结论：SGLT-2i使用者患癌症的风险低于磺脲类、GLP-1a和DPP-4i使用者。这些结果可能通过指导未来的临床实践和药物选择来提高患者的安全性。未来的研究应该调查这些观察到的关联背后的机制。试验注册：该NMA在PROSPERO注册（CRD42023469941）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Drug Safety Medicine-Pharmacology (medical)

CiteScore

6.70

自引率

4.50%

发文量

审稿时长

9 weeks

期刊介绍： Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.