- Sodium-glucose cotransporter-2 inhibitor (SGLT-2i) use does not seem to raise the risk for urinary tract infections (UTIs).
Why this matters
- The association between SGLT-2is and UTIs has been unclear.
- All SGLT-2i labels carry an FDA warning about severe UTIs.
- Study of 2 US claims databases of propensity-matched cohorts with type 2 diabetes (T2D) initiating new second-line agents:
- Cohort 1: 123,752 SGLT-2is vs dipeptidyl peptidase-4 inhibitors (DPP-4is); and
- Cohort 2: 111,978 SGLT-2is vs glucagon-like peptide-1 receptor agonists (GLP-1RAs).
- Severe UTI: hospitalization for primary UTI, sepsis with UTI, or pyelonephritis.
- Funding: Harvard Medical School.
- Cohort 1: 61,876 matched pairs:
- 61 severe UTI events.
- Incidence ratio (IR): 1.76 cases/1000 person-years.
- 57 severe events.
- IR: 1.77/1000 person-years.
- Adjusted HR, 0.98 (P=.93).
- Cohort 2: 55,989 matched pairs:
- 73 events.
- IR: 2.15/1000 person-years.
- 87 events.
- IR: 2.96/1000 person-years.
- HR, 0.72 (P=.040).
- SGLT-2is were not associated with increased risk for UTI hospitalizations (HRs; 95% CIs):
- Cohort 1: 0.68 (0.54-0.87);
- Cohort 2: 0.78 (0.62-0.99).
- SGLT-2is were not associated with treated outpatient UTIs (HRs; 95% CIs):
- Cohort 1: 0.96 (0.89-1.04);
- Cohort 2: 0.91 (0.84-0.99).
- Observational, not randomized.
- All commercially insured population.
- Excluded those at highest UTI risk.