Newer Glucose-Lowering Drugs and Risk of Gout: A Network Meta-Analysis of Randomized Outcomes Trials

IF 3.2 4区医学 Q2 PHARMACOLOGY & PHARMACY Clinical therapeutics Pub Date : 2024-11-01 DOI:10.1016/j.clinthera.2024.04.013

Aihua Wang , Weilong Shi , Ning Zhang , Huilin Tang , Xin Feng

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Abstract

Purpose

Previous studies have shown that newer glucose-lowering drugs (GLDs), such as sodium-glucose transport protein 2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dipeptidyl peptidase 4 (DPP-4) inhibitors, may decrease the risk of gout, however, the evidence remains inconclusive. This study aimed to assess the association between newer GLDs and risk of gout.

Methods

We systematically searched electronic databases up to August 2023 to include randomized, placebo-controlled outcome trials that reported gout-related outcomes in participants with and without type 2 diabetes. A random effects network meta-analysis was conducted to estimate the risk ratio (RR) with 95% confidence interval (CI) to compare the effects of SGLT2 inhibitors, GLP-1RAs, and DPP-4 inhibitors on risk of gout.

Findings

This study included 22 trials involving 173,498 patients. Compared with placebo, SGLT2 inhibitors were significantly associated with decreased risk of gout (RR, 0.51; 95% CI, 0.29–0.91) while both GLP-1RAs and DPP-4 inhibitors have no significant effects on gout risk. There were no significant differences between SGLT2 inhibitors and GLP-1RAs (RR, 0.75; 95%CI, 0.31–1.82) and between GLP-1RAs and DPP-4 inhibitors (RR, 0.39; 95%CI, 0.14–1.10).

Implications

SGLT2 inhibitors may potentially prevent the risk of gout, however, both GLP-1RAs and DPP-4 inhibitors have neutral effects.

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新型降糖药物与痛风风险：随机结果试验的网络元分析

目的以往的研究表明，钠-葡萄糖转运蛋白2（SGLT2）抑制剂、胰高血糖素样肽-1受体激动剂（GLP-1RA）和二肽基肽酶4（DPP-4）抑制剂等新型降糖药物（GLDs）可能会降低痛风的风险，但相关证据仍不确定。本研究旨在评估新型 GLDs 与痛风风险之间的关联。方法我们系统地检索了截至 2023 年 8 月的电子数据库，以纳入报告了 2 型糖尿病患者和非 2 型糖尿病患者痛风相关结果的随机安慰剂对照结果试验。我们进行了随机效应网络荟萃分析，估算了风险比（RR）和95%置信区间（CI），以比较SGLT2抑制剂、GLP-1RAs和DPP-4抑制剂对痛风风险的影响。与安慰剂相比，SGLT2 抑制剂与痛风风险的降低有显著相关性（RR，0.51；95% CI，0.29-0.91），而 GLP-1RA 和 DPP-4 抑制剂对痛风风险没有显著影响。SGLT2抑制剂和GLP-1RA之间（RR，0.75；95%CI，0.31-1.82）以及GLP-1RA和DPP-4抑制剂之间（RR，0.39；95%CI，0.14-1.10）无明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical therapeutics 医学-药学

CiteScore

6.00

自引率

3.10%

发文量

154

审稿时长

9 weeks

期刊介绍： Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Editors. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases.