Empagliflozin and Risk of Incident Gout: Analysis from the EMPagliflozin Comparative Effectiveness and SafEty (EMPRISE) Cohort Study.
J Gen Intern Med
; 39(10): 1870-1879, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38710868
ABSTRACT
BACKGROUND:
Hyperuricemia is frequently observed in patients with type 2 diabetes (T2D) and is associated with increased risk of gout and cardiovascular disease (CVD). Empagliflozin lowers serum urate levels by enhancing its urinary excretion.OBJECTIVE:
To compare initiators of empagliflozin vs dipeptidyl peptidase-4 inhibitor (DPP4i) and initiators of empagliflozin vs glucagon-like peptide-1 receptor agonist (GLP-1RA) with respect to the risk of incident gout events. DESIGN ANDPARTICIPANTS:
Using three claims-based datasets from 08/2014 to 09/2019, we generated two cohorts (cohort 1 empagliflozin vs DPP4i; cohort 2 empagliflozin vs GLP-1RA) of adult patients with T2D and without prior history of gout or gout-specific medication dispensing separately in each dataset. To assess the risk of incident gout, we estimated hazard ratios (HR) and rate differences (RD) per 1000 person-years (PY) with their 95% confidence intervals (CI) before and after 11 propensity score (PS) matching adjusting for 141 baseline covariates. KEYRESULTS:
We identified 102,262 pairs of 11 propensity score-matched adults in cohort 1 and 131,216 pairs in cohort 2. Over a mean follow-up period of 8 months on treatment, the risk of gout was lower in patients initiating empagliflozin compared to DPP4i (HR = 0.69 95% CI (0.60-0.79); RD = - 2.27 95% CI (- 3.08, 1.46)) or GLP-1RA (HR = 0.83 95% CI (0.73-0.94); RD = - 0.99 95% CI (- 1.66, - 0.32)). Results were consistent across subgroups (sex, age, body mass index, chronic kidney disease, heart failure, cardiovascular disease, and concurrent diuretic use) and sensitivity analyses.CONCLUSIONS:
Among adults with T2D, the initiation of empagliflozin vs a DPP4i or GLP-1RA was associated with lower risk of incident gout, complementing results from a post hoc analysis of the EMPA-REG OUTCOME trial and previously published observational research focusing on the sodium-glucose co-transporter-2 inhibitor class in more narrowly defined study populations.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Compuestos de Bencidrilo
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Diabetes Mellitus Tipo 2
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Inhibidores del Cotransportador de Sodio-Glucosa 2
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Glucósidos
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Gota
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Gen Intern Med
Asunto de la revista:
MEDICINA INTERNA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos