Patients with diabetes and gout may benefit from treatment with SGLT2is

Abstract: https://www.acpjournals.org/doi/10.7326/M23-0724    

URL goes live when the embargo lifts 

A study of persons with gout and type 2 diabetes found that the use of sodium–glucose cotransporter-2 inhibitors (SGLT2is) may reduce recurrent flares and gout-primary emergency department (ED) visits and hospitalizations compared to treatment with dipeptidyl peptidase 4 inhibitors (DPP-4is). SGLT2is may also provide greater cardiovascular benefits in this population. The findings are published in Annals of Internal Medicine.

Gout is an increasingly common metabolic inflammatory disease. Suboptimal care of the disease is associated with recurrent flares, increasing ED visits, and hospitalizations. Gout flares have also been associated with an increased cardiovascular risk and many cardiometabolic comorbidities accompany gout, including type 2 diabetes, metabolic syndrome, chronic kidney disease, and cardiovascular disease. Interventions that can address both gout flares and cardiometabolic risk may be beneficial for many patients.

Researchers from Massachusetts General Hospital conducted a propensity score–matched, new-user cohort study of 8150 persons with both gout and type 2 diabetes. They found that the use of SGLT2is was associated with a 34 percent lower rate of recurrent gout flare compared to DPP-4is, and a 48 percent lower rate of flares requiring an ED visit or hospitalization. The authors also found that SGLT2i use was associated with a relative risk reduction of 31 percent for myocardial infarction. According to the authors, these findings suggest that SGLT2is could have a much-needed ability to simultaneously reduce the burden of recurrent gout flares and coronary sequelae in patients with gout and type 2 diabetes.

Media contacts: For an embargoed PDF, please contact Addison Dunlap at [email protected]. To speak with the corresponding author, Hyon K. Choi, MD, DrPH, please contact [email protected]