Journal of the National Cancer Institute · 2026
Impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors on hematologic malignancy risk: Insights from Japanese claims data.
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Kawashiri Takehiro, Yamamoto Naru, Fujiwara Masaki, Shimizu Tadashi, Kobayashi Daisuke, Fujita Shunsuke, Shibata Nobuhito, Hirota Takeshi, Uchida Mayako
Аннотация
BACKGROUND: Hematologic malignancies, including leukemias and lymphomas, remain life-threatening diseases for which preventive strategies have not yet been established. Recent studies have suggested that sodium-glucose cotransporter 2 (SGLT2) inhibitors have cancer-suppressive properties. This study investigated whether SGLT2 inhibitors are associated with reduced risk of hematologic malignancies in patients with diabetes, using a large-scale medical database.
METHODS: Data of patients with diabetes prescribed diabetes medications were extracted from the JMDC Payer database (January 2005 to November 2023). After exclusions, patients were categorized into SGLT2 inhibitor (n = 158 877) and non-SGLT2 inhibitor (n = 118 678) groups. Propensity score matching, accounting for patient characteristics, resulted in 102 478 matched patients per group. The primary endpoint was time to hematologic malignancy; secondary endpoints were time to lymphoma, leukemia, and their subcategories.
RESULTS: The incidence of hematologic malignancies was lower in the SGLT2 inhibitor group than in the non-SGLT2 inhibitor group (P < .001, hazard ratio [HR] = 0.73, 95% CI = 0.62 to 0.86, risk difference at 5 years (RD) = -0.16%). Lymphoma incidence was also lower in the SGLT2 inhibitor group (P = .003, HR = 0.71, 95% CI = 0.57 to 0.89, RD = -0.12%), whereas no clear evidence of difference was observed for leukemia (P = .06, HR = 0.76, 95% CI = 0.57 to 1.01, RD = -0.02%). Lymphocytic leukemia was associated with lower incidence compared to the non-SGLT2 inhibitor group (P = .04, HR = 0.44, 95% CI = 0.19 to 0.99, RD = -0.02%), whereas no clear evidence of difference was observed for myeloid leukemia (P = .12, HR = 0.76, 95% CI = 0.54 to 1.08, RD = -0.01%). Regarding acute myeloid leukemia (AML), the incidence was low in the SGLT2 inhibitor group (P = .001, HR = 0.34, 95% CI = 0.19 to 0.62, RD = -0.05%).
CONCLUSION: SGLT2 inhibitor use may be associated with lower risk of hematologic malignancies in adults with diabetes.
METHODS: Data of patients with diabetes prescribed diabetes medications were extracted from the JMDC Payer database (January 2005 to November 2023). After exclusions, patients were categorized into SGLT2 inhibitor (n = 158 877) and non-SGLT2 inhibitor (n = 118 678) groups. Propensity score matching, accounting for patient characteristics, resulted in 102 478 matched patients per group. The primary endpoint was time to hematologic malignancy; secondary endpoints were time to lymphoma, leukemia, and their subcategories.
RESULTS: The incidence of hematologic malignancies was lower in the SGLT2 inhibitor group than in the non-SGLT2 inhibitor group (P < .001, hazard ratio [HR] = 0.73, 95% CI = 0.62 to 0.86, risk difference at 5 years (RD) = -0.16%). Lymphoma incidence was also lower in the SGLT2 inhibitor group (P = .003, HR = 0.71, 95% CI = 0.57 to 0.89, RD = -0.12%), whereas no clear evidence of difference was observed for leukemia (P = .06, HR = 0.76, 95% CI = 0.57 to 1.01, RD = -0.02%). Lymphocytic leukemia was associated with lower incidence compared to the non-SGLT2 inhibitor group (P = .04, HR = 0.44, 95% CI = 0.19 to 0.99, RD = -0.02%), whereas no clear evidence of difference was observed for myeloid leukemia (P = .12, HR = 0.76, 95% CI = 0.54 to 1.08, RD = -0.01%). Regarding acute myeloid leukemia (AML), the incidence was low in the SGLT2 inhibitor group (P = .001, HR = 0.34, 95% CI = 0.19 to 0.62, RD = -0.05%).
CONCLUSION: SGLT2 inhibitor use may be associated with lower risk of hematologic malignancies in adults with diabetes.