PMID- 37334516
OWN - NLM
STAT- MEDLINE
DCOM- 20230803
LR  - 20231218
IS  - 1463-1326 (Electronic)
IS  - 1462-8902 (Linking)
VI  - 25
IP  - 9
DP  - 2023 Sep
TI  - Serum uric acid lowering and effects of sodium-glucose cotransporter-2 inhibitors 
      on gout: A meta-analysis and meta-regression of randomized controlled trials.
PG  - 2697-2703
LID - 10.1111/dom.15157 [doi]
AB  - AIMS: To pool the effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on 
      gout and to investigate the association of these effects with baseline serum uric 
      acid (SUA), SUA lowering, and underlying conditions, such as type 2 diabetes 
      mellitus (T2DM)/heart failure (HF). METHODS: PubMed, Embase, Web of Science, 
      Cochrane Library and clinical trial registry websites were searched for 
      randomized controlled trials (RCTs) or post hoc analyses (>/=1-year duration; 
      PROSPERO:CRD42023418525). The primary outcome was a composite of gouty 
      arthritis/gout flares and commencement of anti-gout drugs (SUA-lowering 
      drugs/colchicine). Hazard ratios (HRs) with 95% confidence interval (CI) were 
      pooled using a generic inverse-variance method with a random-effects model. 
      Mixed-effects model univariate meta-regression analysis was performed. RESULTS: 
      Five RCTs involving 29 776 patients (T2DM, n = 23 780) and 1052 gout-related 
      events were identified. Compared to placebo, SGLT2 inhibitor use was 
      significantly associated with reduced risk of composite gout outcomes (HR 0.55, 
      95% CI 0.45-0.67; I(2)  = 61%, P < 0.001). Treatment benefits did not differ 
      between trials being conducted exclusively in baseline HF versus those conducted 
      in patients with T2DM (P-interaction = 0.37), but were greater with dapagliflozin 
      10 mg and canagliflozin 100/300 mg (P < 0.01 for subgroup differences). 
      Sensitivity analysis excluding trials that evaluated the effects of empagliflozin 
      10/25 mg (HR 0.68, 95% CI 0.57-0.81; I(2)  = 0%) accentuated the benefits of 
      SGLT2 inhibitors with no between-trial heterogeneity (HR 0.46, 95% CI 0.39-0.55; 
      I(2)  = 0%). Univariate meta-regression found no impact of baseline SUA, SUA 
      lowering on follow-up, diuretic use, or other variables on their anti-gout 
      effects. CONCLUSION: We found that SGLT2 inhibitors significantly reduced the 
      risk of gout in individuals with T2DM/HF. Lack of an association with 
      SUA-lowering effects suggests that metabolic and anti-inflammatory effects of 
      SGLT2 inhibitors may predominantly mediate their anti-gout benefits.
CI  - (c) 2023 John Wiley & Sons Ltd.
FAU - Banerjee, Mainak
AU  - Banerjee M
AUID- ORCID: 0000-0002-6656-8569
AD  - Department of Endocrinology, Institute of Post Graduate Medical Education and 
      Research, Kolkata, India.
FAU - Pal, Rimesh
AU  - Pal R
AUID- ORCID: 0000-0003-4859-9393
AD  - Department of Endocrinology, Post Graduate Institute of Medical Education and 
      Research, Chandigarh, India.
FAU - Maisnam, Indira
AU  - Maisnam I
AD  - Department of Endocrinology, Institute of Post Graduate Medical Education and 
      Research, Kolkata, India.
FAU - Chowdhury, Subhankar
AU  - Chowdhury S
AD  - Department of Endocrinology, Institute of Post Graduate Medical Education and 
      Research, Kolkata, India.
FAU - Mukhopadhyay, Satinath
AU  - Mukhopadhyay S
AD  - Department of Endocrinology, Institute of Post Graduate Medical Education and 
      Research, Kolkata, India.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20230619
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 268B43MJ25 (Uric Acid)
RN  - 0SAC974Z85 (Canagliflozin)
RN  - HDC1R2M35U (empagliflozin)
RN  - IY9XDZ35W2 (Glucose)
RN  - 9NEZ333N27 (Sodium)
SB  - IM
CIN - Ann Intern Med. 2023 Nov;176(11):JC125. PMID: 37931256
MH  - Humans
MH  - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
MH  - Uric Acid
MH  - Randomized Controlled Trials as Topic
MH  - Canagliflozin/therapeutic use
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy
MH  - *Gout/complications/drug therapy/chemically induced
MH  - *Heart Failure/complications
MH  - Glucose/therapeutic use
MH  - Sodium
OTO - NOTNLM
OT  - SGLT2 inhibitors
OT  - T2DM
OT  - anti-inflammatory
OT  - gout
OT  - heart failure
OT  - uric acid
EDAT- 2023/06/19 06:42
MHDA- 2023/08/03 06:43
CRDT- 2023/06/19 03:53
PHST- 2023/05/19 00:00 [revised]
PHST- 2023/04/26 00:00 [received]
PHST- 2023/05/20 00:00 [accepted]
PHST- 2023/08/03 06:43 [medline]
PHST- 2023/06/19 06:42 [pubmed]
PHST- 2023/06/19 03:53 [entrez]
AID - 10.1111/dom.15157 [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2023 Sep;25(9):2697-2703. doi: 10.1111/dom.15157. Epub 2023 
      Jun 19.