Sodium-glucose cotransporter-2 inhibitors and risk of autoimmune rheumatic diseases: population based cohort study
Authors' conclusion
In this large cohort of adults with type 2 diabetes, SGLT-2 inhibitors were associated with an 11% lower risk of autoimmune rheumatic diseases compared with sulfonylureas.
Study context
- Population
- Adults aged ≥18 years with type 2 diabetes, nationwide healthcare database in South Korea, 2012–22
- Participants
- 2,032,157 adults
- Exposure
- SGLT-2 inhibitors vs sulfonylureas
- SGLT-2 inhibitorsn = 552,065
- Sulfonylureasn = 1,480,092reference
- Outcome
- Autoimmune rheumatic disease, defined using a validated algorithm incorporating diagnostic codes and registration in a disease specific nationwide programme
Methodological detailspopulation based, nationwide healthcare database, normalised inverse probability treatment weighting based on propensity score
- Population based
- Nationwide healthcare database
- Normalised inverse probability treatment weighting based on propensity score
Main finding
As reported in the abstract
Incident autoimmune rheumatic diseases · median of nine months' follow-up
Each group vs sulfonylureasHazard ratio (95% CI)
SGLT-2 inhibitors
0.89(0.81–0.98)
Each group vs sulfonylureasRate difference, per 100 000 person years (95% CI)
SGLT-2 inhibitors
−6.50(−11.86 to −1.14)
Observational data: associations, not effects.
Secondary outcomes
ARD in subgroups (age, sex, type of SGLT-2 inhibitor, baseline CVD, obesity status)
- Findings overall consistent among subgroups stratified by age, sex, type of SGLT-2 inhibitor, baseline CVD and obesity status
Genital infections (positive control outcome)
- HR (95% CI) for genital infections, SGLT-2 inhibitors vs sulfonylureas
- 2.78 (2.72 to 2.83)
- Positive control outcome to evaluate residual confounding
Herpes zoster (negative control outcome)
- HR (95% CI) for herpes zoster, SGLT-2 inhibitors vs sulfonylureas
- 1.03 (1.01 to 1.05)
- Negative control outcome to evaluate residual confounding
Original publication
Sodium-glucose cotransporter-2 inhibitors and risk of autoimmune rheumatic diseases: population based cohort study. BMJ. Published 15 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →