Diabetics using SGLT2 Inhibitors have a lower Gout Risk Save

Researchers from the Brigham and Women's Hospital have reported that adults with type 2 diabetes who were treated with SGLT2 inhibitors had a lower risk of gout compared to GLP1 agonist, suggesting that sodium–glucose cotransporter-2 inhibitors may reduce the risk for gout with type 2 diabetes mellitus (T2DM).

Diabetes is a common comorbid condition in patients with gout and newer approaches to T2DM management include the use of glucagon-like peptide-1 receptor (GLP1) agonists, such as Byetta, Victoza, Trulicity, Ozempic, etc.  SGLT2 inhibitors (e.g., Invokana, Farxiga, Jardiance) inhibit reabsorption of glucose in the kidney and have been shown to lower serum uric acid levels.

This population-based new-user cohort study used claims data from a nationwide commercial insurance database, identifying those with T2DM initiating therapy with an SGLT2 inhibitor or a GLP1 agonist. Patients with a history of gout were excluded. The primary outcome was a new diagnosis of gout.

The study included 295,907 T2DM adults with a newly prescribed an SGLT2 inhibitor or a GLP1 agonist.

The gout incidence rate was lower among patients prescribed an SGLT2 inhibitor (4.9 events per 1000 person-years) than those prescribed a GLP1 agonist (7.8 events per 1000 person-years), with an HR of 0.64 (95% CI, 0.57 to 0.72). 

This analysis did not examine uric acid levels in either cohort. SGLT2 inhibitors have been shown to significantly lower uric acid levels in patients with diabetes, particularly in those with normal renal function (Citation source: http://bit.ly/2QQ6EdH)