REDUCTION IN HEPATOCELLULAR CARCINOMA RISK WITH SGLT2 INHIBITORS IN PATIENTS WITH CO-EXISTING HEPATITIS C AND TYPE 2 DIABETES: A GLOBAL MULTICENTER PROPENSITYMATCHED STUDY

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Hepatology

Abstract

Background: Chronic Hepatitis C infection (CHC) and Diabetes Mellitus Type 2 (T2DM) are independent risk factors for the development of Hepatocellular Carcinoma (HCC). Preclinical studies suggest that Sodiumglucose cotransporter-2 receptor inhibitors (SGLT2i) regulate pathways implicated in HCC progression and may inhibit oncogenesis. However, clinical studies are lacking. Using a large research network, this study aimed to evaluate the effect of SGLT2i on the incidence of HCC in patients with concomitant T2DM and CHC. Methods: In this retrospective cohort study and time-toevent analysis, we utilized the TriNetX electronic health records network, encompassing over 120 million patients from January 1, 2005, to December 31, 2022. We included patients aged 18 years or older diagnosed with co-existing T2DM and chronic hepatitis C who had received either previous or current antiviral treatment. Patients with and without SGLT2 inhibitor treatment were matched using propensity scores for age, gender, race, comorbidities, liver-related characteristics, BMI, and background medications. Patients with a prior history of HCC, liver transplant, type 1 diabetes mellitus, or end-stage renal disease were excluded. Using a Cox proportional hazards regression model, we evaluated the association between SGLT2i use and the incidence of HCC in both groups. Results: We identified 1,478 patients in the SGLT2i group and 14,044 patients in the non-SGLT2i group. A total of 1,448 patients were included after propensity matching from both groups. Table 1 contains the baseline demographics, comorbid conditions, and baseline medications before and after propensity matching. The incidence of HCC was 6.63% in the SGLT2i group vs. 10.42% in the non-SGLT2i group (RR = 0.64, 95% CI(0.49-0.81), P < 0.01). This association remained significant regardless of age, gender, ethnicity, diabetes, hypertension, cirrhosis, and background diabetic medications (metformin, sulfonylurea, glitazone, DPP4i,alpha-glucosidase inhibitors, glucagon-like peptide 1 receptor agonists, and insulin). Conclusion: Based on a large global retrospective study of patients with co-existing CHC and T2DM, SGLT2i use was associated with a significantly lower risk of HCC. However, confirmation through future large-scale prospective studies is required. (Figure Presented).

Volume

80

First Page

S1420

Last Page

S1421

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