Incretin-based drugs are types of medications used in people with type 2 diabetes to lower blood sugar. While these medications have shown beneficial effects in patients with type 2 diabetes, small studies have shown that they may increase the risk of developing lung cancer. Using data from the United Kingdom Clinical Practice Research Datalink, we will examine whether the use of incretin-based drugs is associated with an increased risk of lung cancer in patients with type 2 diabetes. Because lung cancer is associated with low survival rates, results from this population-based study will provide important information on the safety of these drugs.
Incretin-based drugs, which include dipeptidylpeptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, are second- to third-line therapies used in the treatment of type 2 diabetes. While these drugs have been associated with a lower risk of hypoglycaemia and favourable effects on body weight, they may also have an effect on lung tissue, raising the concern that long-term use may be associated with an increased risk of lung cancer. While trials reported imbalances of this adverse event between randomized groups, these trials were not designed or powered to assess this safety outcome. Thus, to address this question, we will assemble a cohort of approximately 150,000 patients newly-treated with antidiabetic drugs between January 2007 and March 2017. Time-dependent Cox proportional hazards models will be used to estimate hazard ratios with 95% confidence intervals of lung cancer associated with use of DPP-4 inhibitors and GLP-1 receptor agonists, compared with use of other second-to-third line antidiabetic drugs. Secondary analyses will assess whether the risk varies by duration of use and individual type of incretin-based drug.
Incident diagnosis of lung cancer.
Samy Suissa - Chief Investigator - Sir Mortimer B Davis Jewish General Hospital
Samy Suissa - Corresponding Applicant - Sir Mortimer B Davis Jewish General Hospital
Hui Yin - Collaborator - Sir Mortimer B Davis Jewish General Hospital
Julie Rouette - Collaborator - McGill University
Laurent Azoulay - Collaborator - McGill University
Nathaniel Bouganim - Collaborator - McGill University
Oriana Hoi Yun Yu - Collaborator - Sir Mortimer B Davis Jewish General Hospital
Robert Platt - Collaborator - McGill University