SGLT2 Inhibitors Reduce Gout Flares and CV Events Save
A cohort analysis shows that gout patients initiating sodium–glucose cotransporter-2 inhibitors (SGLT2is) had lower serum urate levels and fewer gouty flares requiring emergency department (ED) visits or hospitalizations.
Patients with gout and type 2 diabetes were drawn from the general population (1 January 2014 to 30 June 2022) and followed for the primary outcome - recurrent gout flare (ascertained by ED visits, hospitalization, outpatient, and medication dispensing records). Patients starting SGLT2is were compared to those initiating ipeptidyl peptidase 4 inhibitors (DPP-4is).
The gout flare rate was lower among SGLT2i initiators than DPP-4i initiators (52.4 and 79.7 events per 1000 person-years, respectively), with a rate ratio (RR) of 0.66 (95% CI, 0.57 to 0.75), regardless of whether they presented as ED visits or hospitalizations.
Secondary outcomes also favored SGLT2is, including myocardial infarction (HR 0.69; CI, 0.54 to 0.88), and stroke (HR 0.81; CI, 0.62 to 1.05), but those who initiated SGLT2is had a 2 fold higher risk for genital infection (HR, 2.15 [CI, 1.39 to 3.30]).
SGLT2is use in gout may reduce recurrent gouty flares in addition to other cardiovascular benefits.