- Adults with type 2 diabetes (T2D) prescribed a sodium-glucose cotransporter-2 (SGLT2) inhibitor had lower subsequent gout rates than those prescribed a glucagon-like peptide-1 receptor agonist (GLP1-RA).
Why this matters
- Adults with gout have ~30% higher rate of cardiovascular disease (CVD) and all-cause mortality compared with those without gout.
- Febuxostat reduces gout attack risk but is linked to increased CVD risk vs allopurinol.
- US commercial insurance database, March 2013-December 2017.
- Gout rates were compared in propensity-matched patients with T2D and no prior/current gout newly initiating SGLT2 inhibitors (SGLT2is) or GLP1-RAs (n=119,530 per group).
- Funding: Brigham and Women's Hospital.
- Gout diagnoses per 1000 person-years: 4.9 with SGLT2i vs 7.8 with GLP1-RA.
- Adjusted HR, 0.64 (95% CI, 0.57-0.72).
- Absolute rate difference between propensity score-matched SGLT2i and GLP1-RA groups:
- −2.85 (95% CI, −3.59 to −2.12) per 1000 person-years.
- Consistent regardless of age, sex, and baseline diuretic use.
- In sensitivity analysis comparing new SGLT2i users with propensity score-matched new dipeptidyl peptidase-4 inhibitor users (97,442/group), HR for gout with SGLT2i was 0.66 (95% CI, 0.58-0.75).
- Propensity matching excludes some patients.
- Incomplete baseline laboratory data.
- Short follow-up (~280 days).