SGLT2i use linked to reduced risk for flare in adults with gout, T2D

For patients with gout and type 2 diabetes, sodium-glucose cotransporter-2 inhibitors (SGLT2is) are associated with a reduced risk for recurrent gout flares and gout-primary emergency department visits and hospitalizations, and they confer cardiovascular benefits, according to a study published online July 25 in the Annals of Internal Medicine.

Natalie McCormick, Ph.D., from Massachusetts General Hospital in Boston, and colleagues compared gout flares and cardiovascular events among patients with gout and type 2 diabetes initiating SGLT2is versus dipeptidyl peptidase 4 inhibitors (DPP-4is) in a propensity score-matched cohort study.

The researchers found that the flare rate was lower among SGLT2i initiators than DPP-4i initiators after propensity score matching (52.4 versus 79.7 events per 1,000 person-years, respectively; rate ratio [RR], 0.66; rate difference [RD], −27.4 per 1,000 person-years). For gout-primary emergency department visits and hospitalizations, the corresponding RR and RD were 0.52 and −3.4 per 1,000 person-years.

For myocardial infarction, the corresponding hazard ratio and RD were 0.69 and −7.6 per 1,000 person-years. The hazard ratio for stroke was not significantly lower. A higher risk for genital infection was seen for those who initiated SGLT2is (hazard ratio, 2.15); the risk for osteoarthritis encounter was not altered.

"Given the pleiotropic cardiometabolic benefits associated with SGLT2is among patients with type 2 diabetes, this class of medications may be a particularly attractive addition to our current urate-lowering therapies to simultaneously address the high burden of gout and cardiometabolic sequelae," the authors write.

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