Genito-urinary infectious adverse events related to sodium glucose cotransporter-2 inhibitors: a network meta-analysis and meta-regression.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Review of Clinical Pharmacology Pub Date : 2024-05-01 Epub Date: 2024-05-16 DOI:10.1080/17512433.2024.2355287

Kannan Sridharan, Gowri Sivaramakrishnan

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引用次数: 0

Abstract

Introduction: Sodium glucose cotransporter-2 inhibitors (SGLT2is) are an emerging class of drugs with wide indications. Controversial evidence exists regarding the risk of urinary tract infection (UTI) and genital infections (GI) with SGLT2is paving way for undertaking this network meta-analysis and meta-regression study.

Methods: Data from randomized trials evaluating SGLT2is reporting the number of patients with UTI and GI were included. Odds ratios (OR) with 95% confidence intervals (95% CI) were the effect estimates. Meta-regression analysis identified risk factors. Number needed to harm (NNH) was estimated.

Results: Two hundred and sixty-four articles were included [UTI (213 studies; 150,140 participants) and GI (188 studies; 121,275 participants)]. An increased risk of UTI (OR: 1.11; 95% CI: 1.06, 1.16) and GI (OR: 3.5, 95% CI: 3.1, 3.9) was observed. Men showed a lower risk of UTI (OR: 0.2; 95% CI: 0.2, 0.3) and GI (OR: 0.4; 95% CI: 0.4, 0.5). Meta-regression analyses revealed BMI ≥ 30 kg/m² and duration of SGLT2i treatment for ≥6 months as risk factors. NNH was 16 for UTI and 25 for GI.

Conclusion: SGLT2is increase the risk of UTI and GI that needs to be incorporated in the treatment guidelines with precautions in high-risk patients.

Prospective protocol registration: https://osf.io/5fwyk.

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与钠葡萄糖共转运体-2抑制剂相关的泌尿生殖系统感染不良事件：网络荟萃分析和荟萃回归。

简介：葡萄糖钠共转运体-2抑制剂（SGLT2is）是一类新兴药物，具有广泛的适应症。有关 SGLT2is 的尿路感染（UTI）和生殖器感染（GI）风险的证据存在争议，这为开展本网络荟萃分析和荟萃回归研究铺平了道路：方法：纳入评估 SGLT2 的随机试验数据，这些数据报告了 UTI 和 GI 患者的人数。效应估计值为具有 95% 置信区间 (95% CI) 的比值比 (OR)。元回归分析确定了风险因素。结果：共纳入 264 篇文章[UTI（213 项研究；150 140 名参与者）和消化道疾病（188 项研究；121 275 名参与者）]。观察到UTI（OR：1.11；95% CI：1.06，1.16）和消化道疾病（OR：3.5，95% CI：3.1，3.9）的风险增加。男性患尿毒症（OR：0.2；95% CI：0.2，0.3）和消化道疾病（OR：0.4；95% CI：0.4，0.5）的风险较低。元回归分析显示，体重指数≥30 kg/m2和SGLT2i治疗时间≥6个月是风险因素。UTI的NNH为16，消化道疾病的NNH为25：结论：SGLT2i会增加UTI和消化道感染的风险，需要纳入治疗指南，并对高危患者采取预防措施。前瞻性方案注册：https://osf.io/5fwyk。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.