29 Aug 2023 • This study aimed to investigate the association between sodium-glucose cotransporter-2 inhibitors (SGLT2i) and the risk of recurrent gout flares and all-cause mortality in patients with both gout and type 2 diabetes. The analysis involved 5931 patients, with a mean age of 66.0 years, of which 1548 initiated SGLT2i treatment and 4383 initiated treatment with active comparators such as glucagon-like peptide-1 receptor agonists (GLP-1 RA) or dipeptidyl peptidase-4 inhibitors (DPP-4i).

The study found the following associations:

1. The relative rate of recurrent gout flares was 21% lower in patients treated with SGLT2i compared to those treated with active comparators (relative rate: 0.79; 95% CI: 0.65-0.97).
2. This reduced risk of recurrent flares was consistent when comparing SGLT2i with either DPP-4i or GLP-1 RA.
3. The first recurrent flare rate for SGLT2i was significantly lower than for active comparators, with a rate difference of -8.8 per 1000 person-years and a hazard ratio of 0.81 (95% CI: 0.65-0.98).
4. All-cause mortality was lower for patients on SGLT2i compared to active comparators, with a rate difference of -6.1 per 1000 person-years and a hazard ratio of 0.71 (95% CI: 0.52-0.97).

In conclusion, this cohort study suggests that SGLT2 inhibitors are associated with a lower risk of recurrent gout flares and all-cause mortality in patients with both gout and type 2 diabetes. These findings suggest that SGLT2 inhibitors could potentially alleviate the burden of recurrent gout flares and narrow the mortality gap between individuals with gout and the general population. Source: JAMA | Read full story