| アブストラクト | OBJECTIVES: Sodium-glucose cotransporter-2 (SGLT2) inhibitor-induced glycosuria is hypothesized to increase the risk of urinary tract infections (UTIs). We assessed the risk of UTIs associated with SGLT2 inhibitor initiation in type 2 diabetes. METHODS: We conducted a population-based cohort study using primary care data from the United Kingdom's Clinical Practice Research Datalink (CPRD) and administrative health-care data from Alberta, Canada. From a base cohort of new metformin users, we constructed 5 comparative cohorts, wherein the exposure contrast was defined as new use of SGLT2 inhibitors or 1 of 5 active comparators: dipeptidylpeptidase-4 (DPP-4) inhibitors, sulfonylureas (SU), glucagon-like peptide-1 receptor agonists (GLP-1 RA), thiazolidinediones (TZD) and insulin. We defined a composite UTI outcome based on hospitalizations or physician visit records. For each comparative cohort, we used high-dimensional propensity score matching to adjust for confounding and Cox proportional hazards regression to estimate the hazard ratios (HRs) in each database. We meta-analyzed estimates using a random-effects model. RESULTS: SGLT2 inhibitor use was not associated with a higher risk of UTI compared with DPP-4 inhibitors (pooled HR, 1.08; 95% confidence interval [CI], 0.89 to 1.30), SU (pooled HR, 1.08; 95% CI, 0.90 to 1.30), GLP-1 RA (pooled HR, 0.81; 95% CI, 0.61 to 1.09) or TZD (pooled HR, 0.81; 95% CI, 0.55 to 1.19). The risk of UTI was lower compared with insulin (pooled HR, 0.74; 95% CI, 0.63 to 0.87). The risk of UTI did not differ based on the SGLT2 inhibitor agent or dose. Last, SGLT2 inhibitor initiation was not associated with an increased risk of UTI recurrence. CONCLUSION: SGLT2 inhibitor use is not associated with an increased risk of UTIs, compared with other antidiabetic agents. |
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| ジャーナル名 | Canadian journal of diabetes |
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| 投稿日 | 2022/5/7 |
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| 投稿者 | Alkabbani, Wajd; Zongo, Arsene; Minhas-Sandhu, Jasjeet K; Eurich, Dean T; Shah, Baiju R; Alsabbagh, Mhd Wasem; Gamble, John-Michael |
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| 組織名 | School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada.;Faculty of Pharmacy and CHU de Quebec Research Center, Universite Laval, Quebec;City, Quebec, Canada.;School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada; School of;Public Health, University of Alberta, Edmonton, Alberta, Canada.;School of Public Health, University of Alberta, Edmonton, Alberta, Canada.;Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division;of Endocrinology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.;School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada. Electronic;address: jm.gamble@uwaterloo.ca. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35513988/ |
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