Department of Pharmacy, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.
Department of Pharmacy, Peking University Third Hospital, Beijing, China.
Clin Ther. 2024 Nov;46(11):851-854. doi: 10.1016/j.clinthera.2024.04.013. Epub 2024 May 24.
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.
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.
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).
SGLT2 inhibitors may potentially prevent the risk of gout, however, both GLP-1RAs and DPP-4 inhibitors have neutral effects.
先前的研究表明，新型降糖药物（GLD），如钠-葡萄糖协同转运蛋白 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，可能降低痛风风险，但证据仍不明确。本研究旨在评估新型 GLD 与痛风风险的关系。
我们系统地检索了截至 2023 年 8 月的电子数据库，纳入了报告有或无 2 型糖尿病患者中与痛风相关结局的随机、安慰剂对照结局试验。采用随机效应网络荟萃分析估计风险比（RR）及其 95%置信区间（CI），以比较 SGLT2 抑制剂、GLP-1RA 和 DPP-4 抑制剂对痛风风险的影响。
本研究纳入了 22 项试验，涉及 173498 名患者。与安慰剂相比，SGLT2 抑制剂显著降低痛风风险（RR，0.51；95%CI，0.29-0.91），而 GLP-1RA 和 DPP-4 抑制剂对痛风风险无显著影响。SGLT2 抑制剂与 GLP-1RA 之间（RR，0.75；95%CI，0.31-1.82）和 GLP-1RA 与 DPP-4 抑制剂之间（RR，0.39；95%CI，0.14-1.10）无显著差异。
SGLT2 抑制剂可能有预防痛风风险的作用，但 GLP-1RA 和 DPP-4 抑制剂的作用则为中性。
