SGLT-2: Are They Linked to UTI Risk?

Use of sodium-glucose cotransporter-2 (SGLT-2) inhibitors does not appear to be associated with an increased risk for severe urinary tract infections (UTIs) compared with use of other diabetes medications, according to the results of a recent study.

Previous research on the risk of UTIs with SGLT-2 inhibitor use has yielded conflicting results. To explore this issue further, the researchers conducted a population-based cohort study using data from 2 US-based databases of commercial claims. Patients had type 2 diabetes mellitus and were initiating SGLT-2 inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, or glucagon-like peptide-1 receptor (GLP-1) agonists.

Overall, in the cohort comparing SGLT-2 inhibitors and DPP-4 inhibitors, patients taking SGLT-2 inhibitors experienced 61 severe UTI events (incidence rate [IR] 1.76) compared with 57 events in DPP-4 inhibitor users (IR 1.77). In the cohort comparing SGLT-2 inhibitors and GLP-1 agonists, those taking SGLT-2 inhibitors experienced 73 events (IR 2.15) compared with 87 events (IR 2.96) in the GLP-1 agonist group.

“In a large cohort of patients seen in routine clinical practice, risk for severe and non-severe UTI events among those initiating SGLT-2 inhibitor therapy was similar to that among patients initiating treatment with other second-line antidiabetic medications.”

—Michael Potts

Reference:

Dave CV, Schneeweiss S, Kim D, et al. Sodium–glucose cotransporter-2 inhibitors and the risk for severe urinary tract infections: a population-based cohort study [published online July 30, 2019. Ann Intern Med. DOI: 10.7326/M18-3136