SGLT-2 inhibitors and the risk of infections: a systematic review and meta-analysis of randomized controlled trials.

Acta Diabetologica
Robert PuckrinKristian B Filion

Abstract

There is concern about the infection-related safety profile of sodium-glucose co-transporter 2 (SGLT-2) inhibitors. We aimed to determine the effect of SGLT-2 inhibitors on genitourinary and other infections via systematic review and meta-analysis of randomized controlled trials (RCTs). We conducted a systematic search of Medline, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov to identify double-blinded RCTs enrolling ≥ 50 patients with type 2 diabetes which compared an SGLT-2 inhibitor to placebo or active comparator. Two independent reviewers extracted data and appraised study quality. Data were pooled using random-effects models. Eighty-six RCTs enrolling 50,880 patients were included. SGLT-2 inhibitors increased the risk of genital infections compared to placebo (relative risk [RR] 3.37, 95% CI 2.89-3.93, I2 0%) and active comparator (RR 3.89, 95% CI 3.14-4.82, I2 0.3%). The risk of urinary tract infection (UTI) was not increased with SGLT-2 inhibitors compared to placebo (RR 1.03, 95% CI 0.96-1.11, I2 0%) or active comparator (RR 1.08, 95% CI 0.93-1.25, I2 22%). In drug-specific analyses, only dapagliflozin 10 mg daily was associated with a significantly increased risk of UTI compared to pla...Continue Reading

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Citations

Nov 13, 2018·Current Opinion in Nephrology and Hypertension·Basset El Essawy, Fouad Kandeel
Jan 4, 2019·Journal of Diabetes·Cagatay E OnderCavit Culha
Mar 6, 2019·Expert Opinion on Pharmacotherapy·Genya Aharon-Hananel, Itamar Raz
Jul 30, 2019·Annals of Internal Medicine·Kristian B Filion, Oriana H Yu
Dec 17, 2019·Annals of Internal Medicine·Chintan V DaveElisabetta Patorno
Dec 17, 2019·Annals of Internal Medicine·Pantelis Sarafidis, Aikaterini Papagianni
Dec 4, 2019·Bioscience, Biotechnology, and Biochemistry·Yong XiaXiao-Li Li
Oct 24, 2019·Nature Reviews. Endocrinology·John Wilding
May 22, 2019·Diabetes·Amber L BeitelsheesSimeon I Taylor
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Mar 4, 2020·MMW Fortschritte der Medizin·Felix von Krogh, Alexander Zink
Aug 28, 2020·Blood·David A Weinstein
Apr 7, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Juan ShenBin Zhao
Jun 19, 2019·BMC Endocrine Disorders·Guntram SchernthanerHarald Sourij
Aug 4, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Lidan YangZhenmei An
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Jan 20, 2021·The Journal of Clinical Investigation·Simeon I TaylorAmber L Beitelshees
Jan 12, 2021·Pharmacoepidemiology and Drug Safety·Vanessa C BrunettiKristian B Filion
Oct 24, 2020·The Nurse Practitioner·Kayla R StoverDaniel M Riche
Feb 9, 2021·Therapeutic Advances in Drug Safety·Ryan PelletierJohn-Michael Gamble

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