The Beneficial Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Anemia in Type 2 Diabetes-A Real-World Study.

Objective: To investigate the impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors on the incidence, complications, and therapeutic demands of anemia in patients with diabetes utilizing real-world data, compared to treatment with dipeptidyl peptidase 4 (DPP4) inhibitors.

Methods: In this retrospective cohort study, the dataset was sourced from the data repositories of Clalit Health Services. From January 1, 2016, through December 31, 2021, we identified patients with type 2 diabetes who received treatment with SGLT2 inhibitors and compared them with a matched control group treated with DPP4 inhibitors using propensity score. The primary endpoint was the prevalence of anemia.

Results: A total of 22 896 patients were included in this study, with 11 448 individuals administered SGLT2 inhibitors, and an equal number treated with DPP4 inhibitors. We found a significant lower hazard of anemia among patients treated with SGLT2 inhibitors (HR = 0.6, 95% CI 0.58-0.63) compared to those treated with DPP4 inhibitors. Moreover, the risk of hospitalizations attributed to anemia was significantly lower with SGLT2 inhibitors (HR 0.67, 95% CI 0.58-0.77). SGLT2 inhibitors were associated with a lower necessity for anemia treatment (HR 0.84, 95% CI 0.78-0.92, P < .001).

Conclusion: SGLT2 inhibitors demonstrated a lower prevalence of anemia and a lower risk of hospitalizations attributed to anemia when compared to treatment with DPP4 inhibitors in patients with diabetes.