Associations Between Sodium-Glucose Co-transporter 2 Inhibitors and Urologic Diseases: Implications for Lower Urinary Tract Symptoms From a Multi-State Health System Analysis.

Autor: Roth BJ; Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH; University of California, Irvine, School of Medicine, Irvine, CA. Electronic address: rothbj@hs.uci.edu., Gill BC; Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH., Khooblall P; Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH., Vallabhaneni S; Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH; Northeast Ohio Medical University College of Medicine, Rootstown, OH., Bole R; Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH., Bajic P; Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
Jazyk: angličtina
Zdroj: Urology [Urology] 2024 Oct; Vol. 192, pp. 119-125. Date of Electronic Publication: 2024 Jun 20.
DOI: 10.1016/j.urology.2024.06.036
Abstrakt: Objective: To analyze the frequency of new urologic visits and urologic diagnoses in patients prescribed sodium-glucose co-transporter-2 inhibitors (SGLT-2is).
Material and Methods: Records from a multi-state health system between 2014 and 2022 were reviewed to identify patients referred for outpatient urology evaluation within 2 years of diabetes medication prescription. Patients were stratified by the prescription of SGLT-2is or another diabetes medication. Frequency of urology visits within 1-year, urologic diagnoses, and prescriptions to treat lower urinary tract symptoms (LUTS) were compared. Patients were stratified by whether they had achieved HbA1c goal (≥7% or <7%) following treatment as well as by sex. Multivariable logistic regression was performed to determine if SGLT-2 use independently predicted outcomes of interest.
Results: 163,827 patients met inclusion criteria. Use of SGLT-2is was associated with a higher frequency of early urologic referral, balanitis/balanoposthitis, overactive bladder, urinary frequency, urgency, and need for LUTS medications in males with HbA1c ≥7%. Females on SGLT-2is with HbA1c ≥7% also had higher rates of urinary incontinence. In those with HbA1c <7%, only balanitis/balanoposthitis and urinary incontinence were higher in the SGLT-2i cohorts for males and females, respectively. Multivariable analysis found SGLT-2i use as predictive of early urology referral, balanitis/balanoposthitis, urinary urgency, frequency, overactive bladder, and need for LUTS medications in males. Multivariable analysis of females demonstrated similar results.
Conclusion: SGLT-2is may lead to worse urologic outcomes and increased utilization of urologic care relative to other diabetic medications. Future studies are necessary to identify which patients are at highest risk of adverse urologic outcomes.
Competing Interests: Declaration of Competing Interest Petar Bajic serves as a consultant for Coloplast Corporation and Boston Scientific. Bradley Gill serves as a consultant for Boston Scientific and Sumitomo Pharma America. All other authors state they have no disclosures.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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