Prevalence and thrombotic risk of SGLT-2 inhibitor-associated erythrocytosis: a retrospective cohort study
Authors' conclusion
SGLT-2 inhibitors are associated with a 16.9% prevalence of erythrocytosis, but thrombotic risk appears primarily driven by pre-existing conditions.
Study context
- Population
- Patients prescribed SGLT2i, 2014–2024
- Participants
- 6,787 patients
- Outcome
- Prevalence of erythrocytosis (Hb > 16.5 g/dL or hematocrit > 49% in men, > 16.0 g/dL or > 48% in women)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Erythrocytosis · median follow-up 530 days (IQR, 277-981)
Erythrocytosis
1145 patients
16.9%
Median Hb rise
1.0 g/dL
IQR, 0.4–1.8
Observational data: associations, not effects.
Further findings
Risk factors for erythrocytosis
- Male sex, OR
- 3.24 (2.47-4.26), p < 0.001 (95% CI)
- BMI ≥ 25 kg/m², OR
- 1.97 (1.63-2.39), p < 0.001 (95% CI)
- Current smoking, OR
- 2.41 (1.96-2.96), p < 0.001 (95% CI)
- Age ≥ 70 years, hypertension, dyslipidemia and CKD associated with reduced risk
Safety
- Thrombosis
- 33 patients (0.5%)
- Antiplatelet use, OR
- 3.57 (1.60-7.97) (95% CI)
- Anticoagulant use, OR
- 5.93 (2.60-13.57) (95% CI)
- Baseline erythrocytosis, OR
- 3.75 (1.41-9.96) (95% CI)
- Thrombosis with erythrocytosis at event and within prior 6 months; all arterial, associated with underlying conditions, not directly attributable to SGLT2-induced erythrocytosis
- 5
Original publication
Prevalence and thrombotic risk of SGLT-2 inhibitor-associated erythrocytosis: a retrospective cohort study. Cardiovasc Diabetol. Published 10 July 2025. doi:10.
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