SGLT2 inhibitors improved composite clinical outcomes in T2DM patients undergoing anthracycline chemotherapy compared to non-SGLT2i users (HR 0.47; 95% CI 0.32-0.69).
Cohort (n=81,572)
Yes
Does SGLT2i reduce the composite of heart failure hospitalization, acute myocardial infarction, ischemic stroke, and death in patients with T2DM undergoing anthracycline-containing chemotherapy?
SGLT2 inhibitors may improve cardiovascular and mortality outcomes in patients with type 2 diabetes undergoing anthracycline-containing chemotherapy.
Effect estimate: HR 0.47 (95% CI 0.32-0.69)
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.
Hwang et al. (Fri,) conducted a cohort in Type 2 diabetes mellitus undergoing anthracycline-containing chemotherapy (n=81,572). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) vs. Other hypoglycemic agents excluding SGLT2i (non-SGLT2i) and non-DM patients was evaluated on Composite of heart failure hospitalization, acute myocardial infarction, ischemic stroke, and death (HR 0.47, 95% CI 0.32-0.69). SGLT2 inhibitors improved composite clinical outcomes in T2DM patients undergoing anthracycline chemotherapy compared to non-SGLT2i users (HR 0.47; 95% CI 0.32-0.69).
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