← SGLT2 inhibitors × adverse events & safety

SynthesisDiabetologia2017

SGLT2 inhibitors and risk of cancer in type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials.

Huilin Tang et al.PubMed ↗Publisher ↗

  • SGLT2 inhibitorslooks bad hereHigher bladder cancer, no clear effect on overall cancer.Randomised, large.
  • Empagliflozinlooks bad hereHigher bladder cancer.Randomised, large.
  • Canagliflozinlooks good hereLower gastrointestinal cancers.Randomised, large.

What the trial testedrandomised · 34,569 people · 2017

Randomised vs placebo or other active glucose-lowering treatments

Raised bladder cancer

3.9×1.5× to 10×

SGLT2 inhibitors vs placebo or other active glucose-lowering treatments

Bigger than 9 in 10 for adverse events & safety

As reported

OR 3.87, 95% CI 1.48–10.1

Randomised vs placebo or other active glucose-lowering treatments

Raised bladder cancer

4.5×1.2× to 17×

empagliflozin vs placebo or other active glucose-lowering treatments

Bigger than almost all for adverse events & safety

As reported

OR 4.49, 95% CI 1.21–16.7

Randomised vs placebo or other active glucose-lowering treatments

Lowered gastrointestinal cancers

−85%−96% to −40%

canagliflozin vs placebo or other active glucose-lowering treatments

Bigger than almost all for adverse events & safety

As reported

OR 0.15, 95% CI 0.04–0.60

Range includes no effect

No clear effect on overall cancer

+14%−4% to +36%

SGLT2 inhibitors vs placebo or other active glucose-lowering treatments

Bigger than 4 in 10 for adverse events & safety

As reported

OR 1.14, 95% CI 0.96–1.36

Who was studied, and how

34,569people with type 2 diabetes, in this paper

The trial randomly assignedassigned by chance

SGLT2 inhibitors
placebo or other active glucose-lowering treatments

Raised bladder cancer3.9×

No clear effect on overall cancer+14%

randomised

The trial randomly assignedassigned by chance

empagliflozin
placebo or other active glucose-lowering treatments

Raised bladder cancer4.5×

randomised

the abstract, start to end

… an increased risk of overall cancer (OR 1.14 [95% CI 0.96, 1.36]).

… be increased with SGLT2 inhibitors (OR 3.87 [95% CI 1.48, 10.08]), especially empagliflozin (OR 4.49 [95% CI 1.21, 16.73]).

… against gastrointestinal cancers (OR 0.15 [95% CI 0.04, 0.60]).

← favours treatmentfavours comparator →
could be chance
Overall cancerSGLT2 inhibitors vs placebo or other active glucose-lowering treatments
OR 1.140.96–1.36
Bladder cancerSGLT2 inhibitors vs placebo or other active glucose-lowering treatments
OR 3.871.48–10.1
Bladder cancerempagliflozin vs placebo or other active glucose-lowering treatments
OR 4.491.21–16.7
Gastrointestinal cancerscanagliflozin vs placebo or other active glucose-lowering treatments
OR 0.150.04–0.60
SGLT2 inhibitorsAdverse events & safety

SGLT2 inhibitors × adverse events & safetyharms?mixed

unlikelylikely
0.00not counted
← favours treatmentfavours comparator →
more certainless certain
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