Iliana C Lega1,2,3, Susan E Bronskill1,3,4, Michael A Campitelli3, Jun Guan3, Nathan M Stall1,4,5, Kenneth Lam1, Lisa M McCarthy1,4,6, Andrea Gruneir1,3,7, Paula A Rochon1,2,3,4. 1. Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. 2. Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 3. ICES, Toronto, Ontario, Canada. 4. Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. 5. Division of Geriatric Medicine, Department of Medicine, University of Toronto, Ontario, Canada. 6. Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada. 7. Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.
Abstract
AIMS: The objective of the study was to quantify the association between SGLT2 inhibitors and genital mycotic infection and between SGLT2 inhibitors and urinary tract infection (UTI) within 30 days of drug initiation among older women and men. MATERIALS AND METHODS: This was a retrospective cohort study using linked administrative databases of women and men with diabetes, aged 66 years or older, in Ontario, Canada. We compared the incidence of genital mycotic infection or UTI within 30 days between new users of an SGLT2 inhibitor and of a dipeptidyl-peptidase-4 (DPP4) inhibitor. RESULTS: We identified 21 444 incident users of SGLT2 inhibitor and 22 463 incident users of DPP4 inhibitor. Among SGLT2 inhibitor users, there were 8848 (41%) women and the mean age at index was 71.8 ± 5 (SD) years. After adjusting for propensity score, age, sex and recent UTI, there was a 2.47-fold increased risk of genital mycotic infection with incident use of SGLT2 inhibitors (adjusted hazard ratio (HR), 2.47; 95% confidence interval (CI), 2.08-2.92; P < 0.001) within 30 days compared to incident use of DPP4 inhibitors. For UTI, the adjusted HR was 0.89 (95% CI, 0.78-1.00; P = 0.05). CONCLUSIONS: Incident use of SGLT2 inhibitors among older women and men is associated with increased risk of genital mycotic infections within 30 days; there is no associated increased risk of UTI. These findings from a real-world setting provide evidence of the potential harms of SGLT2 inhibitors.
AIMS: The objective of the study was to quantify the association between SGLT2 inhibitors and genital mycotic infection and between SGLT2 inhibitors and urinary tract infection (UTI) within 30 days of drug initiation among older women and men. MATERIALS AND METHODS: This was a retrospective cohort study using linked administrative databases of women and men with diabetes, aged 66 years or older, in Ontario, Canada. We compared the incidence of genital mycotic infection or UTI within 30 days between new users of an SGLT2 inhibitor and of a dipeptidyl-peptidase-4 (DPP4) inhibitor. RESULTS: We identified 21 444 incident users of SGLT2 inhibitor and 22 463 incident users of DPP4 inhibitor. Among SGLT2 inhibitor users, there were 8848 (41%) women and the mean age at index was 71.8 ± 5 (SD) years. After adjusting for propensity score, age, sex and recent UTI, there was a 2.47-fold increased risk of genital mycotic infection with incident use of SGLT2 inhibitors (adjusted hazard ratio (HR), 2.47; 95% confidence interval (CI), 2.08-2.92; P < 0.001) within 30 days compared to incident use of DPP4 inhibitors. For UTI, the adjusted HR was 0.89 (95% CI, 0.78-1.00; P = 0.05). CONCLUSIONS: Incident use of SGLT2 inhibitors among older women and men is associated with increased risk of genital mycotic infections within 30 days; there is no associated increased risk of UTI. These findings from a real-world setting provide evidence of the potential harms of SGLT2 inhibitors.
Authors: Shelley A Sternberg; Mirko Petrovic; Graziano Onder; Antonio Cherubini; Denis O'Mahony; Jerry H Gurwitz; Francesco Pegreffi; Robin Mason; Jennifer Akerman; Lisa McCarthy; Andrea Lawson; Joyce Li; Wei Wu; Paula A Rochon Journal: Eur Geriatr Med Date: 2021-04-09 Impact factor: 1.710
Authors: Andrew P McGovern; Michael Hogg; Beverley M Shields; Naveed A Sattar; Rury R Holman; Ewan R Pearson; Andrew T Hattersley; Angus G Jones; John M Dennis Journal: BMJ Open Diabetes Res Care Date: 2020-05