Lower Risk for Gout With SGLT2 Inhibitors vs GLP1 Agonists in Type 2 Diabetes

The following article is a part of conference coverage from the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting, being held in Atlanta, Georgia. The team at Rheumatology Advisor will be reporting on the latest news and research conducted by leading experts in rheumatology. Check back for more from the 2019 ACR/ARP Annual Meeting.

ATLANTA — Among adults with type 2 diabetes mellitus, sodium-glucose cotransporter 2 (SGLT2) inhibitors are associated with a lower rate of gout compared with glucagon-like peptide-1 receptor (GLP1) agonists, according to study results presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting, held November 8 to 13, 2019, in Atlanta, Georgia.

This population-based cohort study included 295,907 adults with type 2 diabetes who received a first-time prescription for an SGLT2 inhibitor or a GLP1 agonist between March 2013 and December 2017. Data were sourced from a United States nationwide commercial insurance database. A 1:1 propensity score matching was performed to match patients prescribed an SGLT2 inhibitor with those prescribed a GLP1 agonist. Patients with a history of gout were excluded. The study’s primary outcome was inpatient gout diagnosis or outpatient gout diagnosis with the use of a gout-related medication within 2 weeks. Further assessments included cellulitis and hospitalization for heart failure. Hazard ratios (HRs) for the primary outcome were computed using Cox proportional hazards.

Of 111,419 pairs of patients (mean age, 54 years; 52% women; 26% received insulin at baseline), those newly prescribed an SGLT2 inhibitor showed a lower rate of gout compared with those newly prescribed a GLP1 agonist (4.9 vs 8.1 events per 1000 person-years; HR, 0.61; 95% CI, 0.54-0.69) during the median 177-day follow-up. Heart failure was also lower with SGLT2 inhibitors (HR, 0.63; 95% CI, 0.51-0.78); however, SGLT2 inhibitors and GLP1 agonists were associated with similar rates of cellulitis (HR, 1.05; 95% CI, 1.00-1.11).

Overall, adults with type 2 diabetes who received an SGLT2 inhibitor had a lower rate of gout compared with those who received a GLP1 agonist.

“SGLT2 inhibitors may reduce the risk of developing gout among adults with type 2 diabetes mellitus, though future studies are necessary to confirm this observation,” the study researchers concluded.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Reference

Fralick M, Chen S, Patorno E, Kim SC. Assessing the risk of gout with sodium glucose co-transporter-2 inhibitors: a population-based cohort study. Presented at: 2019 ACR/ARP Annual Meeting; November 8-13, 2019; Atlanta, GA. Abstract 2834.