磷脂酰肌醇-3-激酶（PI3K）抑制被用于治疗某些癌症，但会导致深度高血糖和胰岛素抵抗，因此有人提出使用钠葡萄糖协同转运体-2（SGLT2）抑制剂作为首选疗法。本研究的目的是评估SGLT2抑制剂用于PI3K抑制引起的高血糖的有效性和安全性。我们对已开始应用PI3K抑制剂阿诺曲库索的成年患者进行了单中心回顾性评估。通过查阅病历记录评估了不同抗糖尿病药物的应用情况以及发生的不良事件，包括酮症酸中毒（DKA）。从电子病历中提取了血浆和即刻血糖数据。通过比较SGLT2抑制剂与其他抗糖尿病药物在血糖变化和DKA发生率上的差异，作为共同主要结局进行检查。我们确定了103名符合资格标准的患者，开始阿诺曲库索后的中位随访时间为92天。在治疗高血糖时，SGLT2抑制剂与调整的线性建模中的随机血糖平均降低了46 mg/dL（95% CI -77 至 -15）。我们确认了5例DKA病例，其中有2例发生在接受阿诺曲库索加SGLT2抑制剂治疗的患者身上。预计DKA发生率为：阿诺曲库索加SGLT2抑制剂，每100患者年48例DKA（95% CI 6, 171）；阿诺曲库索与非SGLT2抑制剂类抗糖尿病药物，每100患者年15例（95% CI 2, 53）；仅阿诺曲库索，每100患者年4例（95% CI 0.1, 22）。SGLT2抑制剂是治疗PI3K抑制引起的高血糖的有效方法。© 2023. 作者（S），在Springer Science+Business Media, LLC的全球独家许可下，Springer Nature的一部分。

Phosphoinositide 3-kinase (PI3K) inhibition is used for the treatment of certain cancers, but can cause profound hyperglycemia and insulin resistance, for which sodium-glucose cotransporter-2 (SGLT2) inhibitors have been proposed as a preferred therapy. The objective of this research is to assess the effectiveness and safety of SGLT2 inhibitors for hyperglycemia in PI3K inhibition.We conducted a single-center retrospective review of adults initiating the PI3K inhibitor alpelisib. Exposure to different antidiabetic drugs and adverse events including diabetic ketoacidosis (DKA) were assessed through chart review. Plasma and point-of-care blood glucoses were extracted from the electronic medical record. Change in serum glucose and the rate of DKA on SGLT2 inhibitor versus other antidiabetic drugs were examined as co-primary outcomes.We identified 103 patients meeting eligibility criteria with median follow-up of 92 days after starting alpelisib. When SGLT2 inhibitors were used to treat hyperglycemia, they were associated with a decrease in mean random glucose by -46 mg/dL (95% CI - 77 to - 15) in adjusted linear modeling. Five cases of DKA were identified, two occurring in patients on alpelisib plus SGLT2 inhibitor. Estimated incidence of DKA was: alpelisib plus SGLT2 inhibitor, 48 DKA cases per 100 patient-years (95% CI 6, 171); alpelisib with non-SGLT2 inhibitor antidiabetic drugs, 15 (95% CI 2, 53); alpelisib only, 4 (95% CI 0.1, 22).SGLT2 inhibitors are effective treatments for hyperglycemia in the setting of PI3K inhibition.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.