Concerns have previously been raised in connection to the possible relationship between treatment with sodium–glucose cotransporter-2 (SGLT-2) inhibitor drugs (e.g. canagliflozin and dapagliflozin ) and risk for severe urinary tract infections (UTIs).Recently published research has examined this issue, comparing the incidence of major UTIs amongst people treated with SGLT-2 inhibitors and against starting dipeptidyl peptidase-4 (DPP-4) inhibitors (the “gliptins”) or glucagon-like peptide-1 receptor (GLP-1) agonists (exanatide).Two cohorts were matched 1:1 on propensity score: subjects adults with type 2 diabetes mellitus initiating treatment. The primary outcome was a severe UTI event (hospitalization for primary UTI, sepsis with UTI, or pyelonephritis) and the secondary outcome was outpatient UTI treated with antibiotics. 123 752 patients were identified in cohort 1 and 111 978 in cohort 2. In cohort 1, persons newly receiving SGLT-2 inhibitors had 61 severe UTI events (incidence rate [IR] per 1000 person-years, 1.76), compared with 57 events in the DPP-4 inhibitor group (IR, 1.77) (HR, 0.98 [95% CI, 0.68 to 1.41]). In cohort 2, those receiving SGLT-2 inhibitors had 73 events (IR, 2.15), compared with 87 events in the GLP-1 agonist group (IR, 2.96) (HR, 0.72 [CI, 0.53 to 0.99]). The risk for UTIs for those starting SGLT-2 inhibitor therapy was similar to that for those commencing treatment with other second-line antidiabetic medications. Read more here.
