Acarbose might be associated with reduced risk of gastric cancer in patients with diabetes mellitus: A nationwide population-based cohort study

Pharmacoepidemiol Drug Saf. 2024 Sep;33(9):e5762. doi: 10.1002/pds.5762.

Abstract

Background: Several epidemiologic studies have revealed a higher risk of cancer in patients with diabetes mellitus (DM) relative to the general population. To investigate whether the use of acarbose was associated with higher/lower risk of new-onset cancers.

Method: We conducted a retrospective cohort study, using a population-based National Health Insurance Research Database of Taiwan. Both inpatients and outpatients with newly onset DM diagnosed between 2000 and 2012 were collected. The Adapted Diabetes Complications Severity Index (aDCSI) was used to adjust the severity of DM. The Cox proportional hazards regression model was used to estimate the hazard ratio (HR) of disease.

Results: A total of 22 502 patients with newly diagnosed DM were enrolled. The Cox proportional hazards regression model indicating acarbose was neutral for risk for gastroenterological malignancies, when compared to the acarbose non-acarbose users group. However, when gastric cancer was focused, acarbose-user group had significantly lowered HR than non-acarbose users group (p = 0.003). After adjusted for age, sex, cancer-related comorbidity, severity of DM, and co-administered drugs, the HR of gastric cancer risk was 0.43 (95% CI = 0.25-0.74) for acarbose-user patients.

Conclusion: This long-term population-based study demonstrated that acarbose might be associated with lowered risk of new-onset gastric cancer in diabetic patients after adjusting the severity of DM.

Keywords: Cox proportional hazards regression model; National Health Insurance Research Database; acarbose; diabetes mellitus; gastric cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acarbose* / administration & dosage
  • Acarbose* / therapeutic use
  • Adult
  • Aged
  • Cohort Studies
  • Databases, Factual
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Stomach Neoplasms* / epidemiology
  • Taiwan / epidemiology

Substances

  • Acarbose
  • Hypoglycemic Agents