Retrospective cohort study of survival impact of GLP-1RAs, SGLT2i, and DPP4i among older adults with cancer and type 2 diabetes

The survival impact of newer glucose-lowering drugs among older adultes with cancer and type 2 diabetes (T2D) is not clear. A retrospective cohort study using 2013 to 2020 Medicare data investigated all-cause mortality with use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) compared with sodium-glucose cotransporter-2 inhibitors (SGLT2is) or dipeptidyl peptidase-4 inhibitors (DPP4is) for T2D among patients with 1 of 9 cancers. Mortality risk did not differ significantly between GLP-1RA and SGLT2i users but was significantly lower with GLP-1RA use compared with DPP41 use. Subgroup analyses revealed no significant differences between GLP-1RAs and SGLT2is. The survival benefit of GLP-1RAs over DPP4is remained consistent across most subgroups.