For some time, there has been concern over sodium-glucose transport-2 (SGLT-2) inhibitors such as Invokana (canagliflozin), Farxiga (dapagliflozin) and Jardiance (empagliflozin), and whether these prescription medications increase a patient's risk of certain types of cancer. A new study published this month in the journal Diabetology shows that SGLT-2 inhibitors do not necessarily increase a patient's cancer risk.
In 2014, a study appearing in the International Journal of Endocrinology found evidence to suggest that the SGLT receptor itself may be involved in glucose uptake process for a number of cancers. The connection between cancer and sugar has been known since the 1920s, although it only has been recently that scientists have started to understand exactly how sugar is involved in the growth of malignant tumors.
SGLT-2 inhibitors, also known as gliflozin drugs, do increase the risk of urinary tract infections, which in turn may increase the risk of bladder cancer. However, people suffering from diabetes already run a higher risk of developing bladder cancer, so the link between gliflozins and the disease has not been entirely clear. An analysis of data from 2014 indicated that patients using SGLT-2 inhibitors were simply being diagnosed earlier and more effectively, since such patients undergo more frequent urinalysis.
The current study was a meta analysis of all randomized clinical trials involving the three gliflozin drugs. Researchers examined records of over 35,500 patients, 580 of whom were suffering melanomas as well as cancer of the bladder, breast and prostate. While there appeared to be a higher rate of cancer among patients who took SGLT-2 inhibitors, the difference was deemed to be statistically insignificant.
Epidemiologist Dr. Yiquing Song, one of the researchers, said, “Our study provides the latest evidence about the association between use of SGLT2 inhibitors and risk of cancer and will help physicians and patients to better understand the risk when choosing these drugs.” However, he cautioned that more study is required in order to understand the relationship between gliflozin drugs and cancer risk. He added, “Given rapidly increasing use of SGLT2 inhibitors, it is our hope that long-term safety of its use be carefully monitored in future clinical trials and real-world settings.”
While this information may come as a relief to those taking Invokana or other drugs of the gliflozin class, the fact remains that Invokana is still known to put patients at a higher risk of diabetic-related amputations, ketoacidosis and pancreatitis. In many cases, these injuries occur after only a few weeks or months taking the drug. Current lawsuits against drugmaker Janssen Pharmaceuticals and parent company Johnson & Johnson allege that the manufacturers were aware of these risks and concealed this information from the FDA and the public.