Dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide receptor agonists (GLP-1 RAs) are commonly prescribed for managing blood glucose levels in type 2 diabetes. These incretin-based drugs have favourable clinical effects and over the years, there has been accumulating biologic evidence that they may reduce the growth of prostate cancer cells. To date, it is unknown whether the incretin-based drugs are protective against prostate cancer when compared to other anti-diabetic drugs, due to the very limited number of studies on the topic. Thus, the goal of this study is to assess the potential association between the incretin-based drugs and the risk of prostate cancer among male patients with type 2 diabetes, using a large population-based cohort. As prostate cancer is one of the most common cancers among males worldwide, results from this study may have important clinical implications for the chemoprevention, and potentially treatment, of this disease.
Dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide receptor agonists (GLP-1 RAs) are commonly prescribed for managing glucose levels in type 2 diabetes. These incretin-based drugs have several advantages over other anti-diabetic drugs, which include their favourable effects on body weight and decreased risk of hypoglycemia. There is also some evidence that these drugs may reduce the growth of prostate cancer cells. To date, however, there is a paucity of research on the association between the use of incretin-based drugs and the incidence of prostate cancer in the real-world setting. Thus, the objective of this study is to determine whether the use of GLP-1 RAs and DPP-4 inhibitors, separately, is associated with a decreased risk of prostate cancer among men with type 2 diabetes. This study using the Clinical Practice Research Datalink will compare new users of incretin-based drugs (DPP-4 inhibitors and GLP-1 RAs) with new users of sulfonylureas from January 01, 2007 to July 31, 2019, with follow-up until July 31, 2020. Propensity score fine stratification will be used to control for confounding, and Cox proportional hazards models will be used to estimate hazards ratios and 95% confidence intervals of prostate cancer associated with the use of incretin-based drugs, compared to the use of sulfonylureas.
The outcome of interest is an incident diagnosis of prostate cancer, as determined by pre-specified Read codes (listed in Appendix 1).
Samy Suissa - Chief Investigator - Sir Mortimer B Davis Jewish General Hospital
Laurent Azoulay - Corresponding Applicant - McGill University
Hui Yin - Collaborator - Sir Mortimer B Davis Jewish General Hospital
Oriana Hoi Yun Yu - Collaborator - Sir Mortimer B Davis Jewish General Hospital
Sally Lu - Collaborator - McGill University