在接受免疫检查点抑制剂治疗的患者中使用钠-葡萄糖共转运体-2 抑制剂。

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Moran Gvili Perelman, Rafael Y Brzezinski, Barliz Waissengrin, Yasmin Leshem, Or Bainhoren, Tammi Arbel Rubinstein, Maxim Perelman, Zach Rozenbaum, Ofer Havakuk, Yan Topilsky, Shmuel Banai, Ido Wolf, Michal Laufer-Perl
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引用次数: 0

摘要

背景:免疫检查点抑制剂(ICIs)彻底改变了癌症的预后。糖尿病(DM)已被证明会对接受 ICIs 治疗的患者产生负面影响。钠-葡萄糖共转运体2抑制剂(SGLT2i)是一种有效的抗糖尿病疗法,可降低全因死亡率和心血管(CV)预后:评估 SGLT2i 对 ICIs 患者全因死亡率和心脏毒性的预后价值:我们对本中心确诊为癌症和 2 型糖尿病(DM2)并接受 ICIs 治疗的患者进行了回顾性分析。根据使用或不使用 SGLT2i 的基线治疗将患者分为两组。主要终点为全因死亡率,次要终点为MACE,包括心肌炎、急性冠脉综合征、心力衰竭和心律失常:组群包括 119 名患者,其中 24 名(20%)患者被分配到 SGLT2i 组。两组患者的心脏风险因素发生率相当,但 SGLT2i 组缺血性心脏病的发生率更高。在中位随访 28 个月期间,61 名(51%)患者死亡,其中 SGLT2i 组的全因死亡率明显较低(21% 对 59%,P = 0.002)。虽然 MACE 没有明显差异,但我们观察到 SGLT2i 组心肌炎和心房颤动病例为零,而非 SGLT2i 组分别为 2 例和 6 例:结论:在接受 ICIs 治疗的癌症和 DM2 患者中,SGLT2i 治疗与较低的全因死亡率相关。需要进一步研究以了解其机制并评估其对心脏毒性的益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sodium-glucose co-transporter-2 inhibitors in patients treated with immune checkpoint inhibitors.

Background: Immune checkpoint inhibitors (ICIs) have revolutionized the prognosis of cancer. Diabetes mellitus (DM) has been shown to have a negative effect on patients treated with ICIs. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are effective antidiabetic therapies associated with reduced all-cause mortality and cardiovascular (CV) outcomes.

Objective: To evaluate the prognostic value of SGLT2i on all-cause mortality and cardiotoxicity among patients treated with ICIs.

Methods: We performed a retrospective analysis of patients diagnosed with cancer and type 2 DM (DM2) and treated with ICIs at our center. Patients were divided into two groups according to baseline treatment with or without SGLT2i. The primary endpoint was all-cause mortality and the secondary endpoint was MACE, including myocarditis, acute coronary syndrome, heart failure, and arrhythmia.

Results: The cohort included 119 patients, with 24 (20%) patients assigned to the SGLT2i group. Both groups exhibited a comparable prevalence of cardiac risk factors, although the SGLT2i group displayed a higher incidence of ischemic heart disease. Over a median follow-up of 28 months, 61 (51%) patients died, with a significantly lower all-cause mortality rate in the SGLT2i group (21% vs. 59%, p = 0.002). While there were no significant differences in MACE, we observed zero cases of myocarditis and atrial fibrillation in the SGLT2i, compared to 2 and 6 cases in the non-SGLT2i group.

Conclusions: SGLT2i therapy was associated with a lower all-cause mortality rate in patients diagnosed with cancer and DM2 and treated with ICIs. Further studies are needed to understand the mechanism and evaluate its benefit on cardiotoxicity.

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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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