Retrospective study of impact of sodium-glucose cotransporter 2 inhibitors on hematologic malignancy risk in Japanese diabetes patients

Recent studies have suggested that sodium-glucose cotransporter 2 (SGLT2) inhibitors have cancer-suppressive properties. A retrospective analysis of the JMDC (formerly Japan Medical Data Center) database investigated whether SGLT2 inhibitor use is associated with reduced risk of hematological malignancies in adult patients with diabetes. The authors identified diabetes patients between January 2005 to November 2023 who used SGLT2 inhibitors (n=158,877) or did not use SGLT2 inhibitors (n=118,678). Propensity score matching resulted in 102,478 matched patients per group. The primary endpoint was time to hematologic malignancy. The incidence of hematologic malignancies was lower in the SGLT2 inhibitor group than in the non-SGLT2 inhibitor group (HR 0.73; p<0.001). Lymphoma incidence was also lower in the SGLT2 inhibitor group (HR 0.71; p=0.003), whereas no clear evidence of difference was observed for leukemia (HR 0.76; p=0.06). Use of SGLT2 inhibitors was associated with lower incidence of lymphocytic leukemia (HR 0.44; p=0.04) and acute myeloid leukemia (HR 0.34; p=0.001) but not of myeloid leukemia (HR 0.76; p=0.12). The authors conclude that SGLT2 inhibitor use may be associated with lower risk of hematologic malignancies in adult patients with diabetes.