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Sodium-glucose cotransporter-2 inhibitors and the risk of lung cancer among patients with type 2 diabetes: a retrospective cohort study

Objective: To determine whether the use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, compared to dipeptidyl peptidase 4 (DPP-4) inhibitors, is associated with a decreased risk of incident lung cancers among patients with type 2 diabetes. Methods: We assembled a new-user, active comparator cohort of SGLT-2 inhibitor and DPP-4 inhibitor users using the United Kingdom Clinical Practice Research Datalink. We fit Cox proportional hazards models with propensity score fine stratification weighting to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for incident lung cancers. Results: Crude lung cancer incidence rates were 0.92 and 1.37 per 1,000 person-years among 47,517 SGLT-2 inhibitor and 129,807 DPP-4 inhibitor users, respectively. No reduced risk of lung cancer was observed among SGLT-2 inhibitor users after weighting (HR 1.08, 95% CI 0.78-1.48). Conclusions: In this large cohort study, the use of SGLT-2 inhibitors was not associated with a decreased risk of lung cancer.