Gout-Related Medication Use After Initiating Sodium–Glucose Cotransporter 2 Inhibitors in Patients With Gout and Type 2 Diabetes: Population-Based Target Trial Emulation Studies
Main finding · Allopurinol initiationResult — go to the resultHazard ratio 0.62 95% CI 0.52–0.73Authors' conclusion
For patients with gout and type 2 diabetes, SGLT2is may reduce gout-related medication use, which could, in turn, reduce exposure to the harmful cardiovascular-kidney-metabolic effects of NSAIDs and glucocorticoids in this high-risk population.
Study context
- Population
- Adults with gout and T2D from a general population database; mean age 66 years, 67% with polypharmacy
- Participants
- 26,739 adults
- Exposure
- SGLT2i vs DPP-4i; GLP-1 RA as alternative comparator
- Outcome
- Allopurinol initiation
Methodological detailsinverse probability of treatment weighting, replication in electronic health record data set
- Inverse probability of treatment weighting
- Replication in electronic health record data set
Main finding
As reported in the abstract
Hazard ratio
0.62
95% CI 0.52–0.73
SGLT2ivs DPP-4i
HR 0.62 (95% CI 0.52–0.73)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Medication dispensing rates (SGLT2i vs DPP-4i)SGLT2ivs DPP-4i | rate ratio, high-dose glucocorticoid 0.78 (95% CI 0.74–0.83) | |
| Medication dispensing rates (SGLT2i vs DPP-4i)SGLT2ivs DPP-4i | rate ratio, NSAID 0.85 (95% CI 0.80–0.92) | |
| Medication dispensing rates (SGLT2i vs DPP-4i)SGLT2ivs DPP-4i | rate ratio, colchicine 0.87 (95% CI 0.83–0.92) | |
| Medication dispensing rates (SGLT2i vs DPP-4i)SGLT2ivs DPP-4i | rate ratio, diuretic 0.87 (95% CI 0.85–0.89) | |
| 0.512Ratio (log scale) |
Allopurinol initiation, by baseline diuretic use
- Associations stronger among those using diuretics at baseline
- P for interaction = 0.03
Allopurinol initiation, SGLT2i vs GLP-1RA and adjusted for serum urate and BMI in secondary data set
- Associations persisted
Original publication
Gout-Related Medication Use After Initiating Sodium–Glucose Cotransporter 2 Inhibitors in Patients With Gout and Type 2 Diabetes: Population-Based Target Trial Emulation Studies. Diabetes Care. Published 30 January 2026. doi:10.
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