Serum urate change among gout patients treated with sodium-glucose cotransporter type 2 inhibitors vs. sulfonylurea: A comparative effectiveness analysis.
Serum urate change among gout patients treated with sodium-glucose cotransporter type 2 inhibitors vs. sulfonylurea: A comparative effectiveness analysis.
复制标题
使用钠-葡萄糖协同转运蛋白 2 型抑制剂与磺酰脲类药物治疗的痛风患者的血清尿酸变化：比较有效性分析。
DOI：
10.1016/j.semarthrit.2024.152441
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发表时间：
2024
影响因子：
5
通讯作者：
Choi,HyonK
中科院分区：
文献类型：
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作者：
Yokose,Chio;Challener,Greg;Jiang,Bohang;Zhou,Baijun;McCormick,Natalie;Tanikella,Sruthi;Panchot,KilaMeiQin;Kohler,MinnaJ;Yinh,Janeth;Zhang,Yuqing;Bates,DavidW;Januzzi,JamesL;Sise,Meghan;Wexler,Deborah;Choi,HyonK
目的探讨血清尿酸盐（SU）的变化，痛风患者开始SGLT 2 i，并与磺脲类药物，第二个最广泛使用的降糖药物后，二甲双胍。MethodsWe进行了一项队列研究，痛风患者和基线SU >6 mg/dL谁有SU测量前90天内和后SGLT 2 i或磺脲类药物开始。使用多变量线性回归，我们比较了SU之间的变化SGLT 2 i发起人之间的糖尿病和非糖尿病，然后比较SU之间的变化SGLT 2 i和sulfonylurea.ResultsWe确定了28例痛风患者启动SGLT 2 i（包括16例糖尿病）和28例患者启动sulfonylurea（所有糖尿病）。在SGLT 2 i启动者中，组内SU平均变化为-1.8（95% CI，-2.4至-1.1）mg/dL，包括-1.2（-1.8至-0.6）mg/dL和-2.5（-3.6至-1.3）mg/dL，分别在糖尿病患者和非糖尿病患者中，糖尿病患者和非糖尿病患者之间的校正差异为-1.4（-2.4至-0.5）mg/dL。开始磺酰脲类药物治疗后SU未发生变化（+0.3 [-0.3至1.0] mg/dL）。在所有患者中，SGLT 2 i与磺酰脲类药物开始治疗之间的校正SU变化差异为-1. 8（-2. 7至-0. 9）mg/dL。无论是否使用降尿酸治疗或利尿剂以及是否存在糖尿病、慢性肾脏疾病或heartful.ConclusionAmong痛风患者，SGLT 2 i与SU显著降低相关，与磺脲类药物相比，无糖尿病患者的降低幅度更大。由于其已被证实的心血管-肾脏-代谢益处，将SGLT 2 i添加到当前的痛风管理中可以为痛风及其合并症提供简化的益处。
ObjectiveTo investigate the serum urate (SU) change among gout patients initiating SGLT2i, and to compare with sulfonylurea, the second-most widely used glucose-lowering medication after metformin.MethodsWe conducted a cohort study of patients with gout and baseline SU >6 mg/dL who had SU measured within 90 days before and after SGLT2i or sulfonylurea initiation. Using multivariable linear regression, we compared SU change among SGLT2i initiators between those with and without diabetes and then compared SU change between SGLT2i and sulfonylurea.ResultsWe identified 28 patients with gout initiating SGLT2i (including 16 with diabetes) and 28 patients initiating sulfonylurea (all with diabetes). Among SGLT2i initiators, the mean within-group SU change was -1.8 (95 % CI, -2.4 to -1.1) mg/dL, including -1.2 (-1.8 to -0.6) mg/dL and -2.5 (-3.6 to -1.3) mg/dL among patients with and without diabetes, respectively, with an adjusted difference between those with and without diabetes of -1.4 (-2.4 to -0.5) mg/dL. The SU did not change after initiating sulfonylurea (+0.3 [-0.3 to 1.0] mg/dL). The adjusted SU change difference between SGLT2i vs. sulfonylurea initiation was -1.8 (-2.7 to -0.9) mg/dL in all patients. The SU reduction persisted regardless of urate-lowering therapy or diuretic use and the presence of diabetes, chronic kidney disease, or heart failure.ConclusionAmong patients with gout, SGLT2i was associated with a notable reduction in SU compared with sulfonylurea, with a larger reduction among patients without diabetes. With their proven cardiovascular-kidney-metabolic benefits, adding SGLT2i to current gout management could provide streamlined benefits for gout and its comorbidities.