Incretin-Based Drugs and the Incidence of Prostate Cancer Among Patients with Type 2 Diabetes
Menée au Royaume-Uni à l'aide de données 2007-2019 portant sur 285 964 personnes atteintes d'un diabète de type 2, cette étude analyse l'effet chimiopréventif de médicaments à base d'incrétines (agonistes des récepteurs du GLP-1 ou d'inhibiteurs de la DPP-4) sur le risque de cancer de la prostate
Background: There is some evidence that glucagon-like peptide 1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors have chemopreventive effects on prostate cancer cells, but real-world evidence for this possible effect is lacking. Thus, the objective of this study was to estimate whether use of GLP-1 receptor agonists and DPP-4 inhibitors, separately, is associated with a decreased risk of prostate cancer among patients with type 2 diabetes. Methods: We assembled two new-user, active comparator cohorts using the United Kingdom Clinical Practice Research Datalink (2007 to 2019). The first cohort included 5063 initiators of GLP-1 receptor agonists and 112,955 of sulfonylureas. The second cohort included 53,529 initiators of DPP-4 inhibitors and 114,417 of sulfonylureas. We fit Cox proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for prostate cancer. We weighted the models using propensity score fine stratification, which considered over 50 potential confounders. Results: GLP-1 receptor agonists were associated with a decreased risk of prostate cancer when compared with sulfonylureas (incidence rates: 156.4 vs. 232.0 per 100,000 person–years, respectively; HR: 0.65, 95% CI: 0.43, 0.99). DPP-4 inhibitors were also associated with a decreased risk of prostate cancer when compared with sulfonylureas (incidence rates: 316.2 vs. 350.5 events per 100,000 person–years, respectively; HR: 0.90, CI: 0.81, 1.00). Conclusions: The results of this study are consistent with the hypothesis that the use of GLP-1 receptor agonists and DPP-4 inhibitors, separately, may decrease the risk of prostate cancer when compared with the use of sulfonylureas.