Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain.
Dental Post Graduate Training Department, PHCC, Manama, Kingdom of Bahrain.
Expert Rev Clin Pharmacol. 2024 May-Jun;17(5-6):515-524. doi: 10.1080/17512433.2024.2355287. Epub 2024 May 16.
Sodium glucose cotransporter-2 inhibitors (SGLT2is) are an emerging class of drugs with wide indications. Controversial evidence exists regarding the risk of urinary tract infection (UTI) and genital infections (GI) with SGLT2is paving way for undertaking this network meta-analysis and meta-regression study.
Data from randomized trials evaluating SGLT2is reporting the number of patients with UTI and GI were included. Odds ratios (OR) with 95% confidence intervals (95% CI) were the effect estimates. Meta-regression analysis identified risk factors. Number needed to harm (NNH) was estimated.
Two hundred and sixty-four articles were included [UTI (213 studies; 150,140 participants) and GI (188 studies; 121,275 participants)]. An increased risk of UTI (OR: 1.11; 95% CI: 1.06, 1.16) and GI (OR: 3.5, 95% CI: 3.1, 3.9) was observed. Men showed a lower risk of UTI (OR: 0.2; 95% CI: 0.2, 0.3) and GI (OR: 0.4; 95% CI: 0.4, 0.5). Meta-regression analyses revealed BMI ≥ 30 kg/m and duration of SGLT2i treatment for ≥6 months as risk factors. NNH was 16 for UTI and 25 for GI.
SGLT2is increase the risk of UTI and GI that needs to be incorporated in the treatment guidelines with precautions in high-risk patients.
钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2is）是一类具有广泛适应证的新兴药物。SGLT2is 引起尿路感染（UTI）和生殖道感染（GI）的风险存在争议，这为进行这项网络荟萃分析和荟萃回归研究铺平了道路。
纳入评估 SGLT2is 报告 UTI 和 GI 患者数量的随机试验数据。比值比（OR）及其 95%置信区间（95%CI）为效应估计值。荟萃回归分析确定了风险因素。危害比（NNH）也进行了估计。
共纳入 264 篇文章[UTI（213 项研究；150140 名参与者）和 GI（188 项研究；121275 名参与者）]。观察到 UTI（OR：1.11；95%CI：1.06，1.16）和 GI（OR：3.5，95%CI：3.1，3.9）的风险增加。男性 UTI（OR：0.2；95%CI：0.2，0.3）和 GI（OR：0.4；95%CI：0.4，0.5）的风险降低。荟萃回归分析显示 BMI≥30kg/m2 和 SGLT2i 治疗时长≥6 个月是风险因素。NNH 为 16（UTI）和 25（GI）。
SGLT2is 增加了 UTI 和 GI 的风险，需要在治疗指南中加入这些风险，并对高危患者采取预防措施。
