Gout, hyperuricaemia meds less common among diabetics on SGLT2is

Patients with type 2 diabetes mellitus (T2DM) taking sodium-glucose cotransporter 2 inhibitors (SGLT2is) are less likely to be prescribed antigout or antihyperuricaemic drugs, a recent study has found.

Researchers conducted a large-scale analysis drawing from the JMDC Claims Database in Japan. They looked at 856,796 T2DM patients who had newly been prescribed the SGLT2is or other antidiabetic drugs, and were not taking antigout/antihyperuricaemic medications at baseline. The endpoint of interest was starting either concomitant medication within 730 days.

After propensity score matching, results showed that SGLT2i patients were more than 60 percent less likely to be prescribed antigout/antihyperuricaemic medications than comparators taking other antidiabetic agents (risk ratio [RR], 0.37, 95 percent confidence interval [CI], 0.20–0.68; p<0.001).

A similar effect was reported for patients who were free of antihypertensive treatment at baseline. After 730 days, T2DM patients on SGLT2is were more than 30 percent less likely to be prescribed antihypertensives than comparators (RR, 0.66, 95 percent CI, 0.47–0.93; p=0.015).

Such an effect could be because SGLT2i treatment is known to reduce blood pressure and uric acid levels, according to the researchers.

An opposite effect was observed for medications against dyslipidaemia. Among those who were not taking such drugs at baseline, new antihyperlipidaemic agent prescriptions were over 40 percent more likely to be documented in the SGLT2i vs other antidiabetic agent groups (RR, 1.43, 95 percent CI, 1.12–1.82; p=0.004).

“This might partly reflect the mild increase in the low-density lipoprotein cholesterol level associated with changes in energy metabolism caused by SGLT2i,” the researchers explained.