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Uso de Medicamentos Relacionados con la Gota Después de Iniciar Inhibidores del Cotransportador de Sodio-Glucosa 2 en
Natalie McCormick1,2,3,4, Nitzan Burrack5, Chio Yokose1,2,3
1Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA.
Diabetes care
|January 30, 2026
Resumen
Los inhibidores del cotransportador de sodio-glucosa 2 (SGLT2i) pueden disminuir la necesidad de medicamentos para la gota en pacientes con diabetes tipo 2. Este hallazgo sugiere que los SGLT2i podrían reducir la exposición a efectos adversos de los tratamientos comunes para la gota.
Área de la Ciencia:
- Ciencia Cardiovascular y Metabólica
- Nefrología
- Reumatología
Sus antecedentes:
- Se sabe que los inhibidores del cotransportador de sodio-glucosa 2 (SGLT2i) reducen los niveles séricos de urato.
- Los SGLT2i se asocian con un menor riesgo de brotes recurrentes de gota.
- Los pacientes con gota a menudo tienen comorbilidades como diabetes tipo 2 y polifarmacia.
Objetivo del estudio:
- Comparar la iniciación y el uso de medicamentos para el manejo de la gota entre los inhibidores de SGLT2 y otros medicamentos para la diabetes.
- Evaluar el uso de alopurinol, antiinflamatorios (glucocorticoides, AINE, colchicina) y diuréticos en pacientes con SGLT2i en comparación con inhibidores de la dipeptidil peptidasa 4 (DPP-4i) o agonistas del receptor del péptido similar al glucagón 1 (GLP-1RA).
Principales métodos:
- Se utilizó la emulación de ensayos dirigidos con una base de datos de población general.
- Se aplicaron regresiones de Cox de riesgos proporcionales y de Poisson con ponderación de probabilidad inversa del tratamiento.
- El análisis se replicó en un conjunto de datos de registros de salud electrónicos, ajustando por urato sérico y IMC.
Principales resultados:
- Los iniciadores de SGLT2 mostraron una menor iniciación de alopurinol (HR 0.62) en comparación con los usuarios de DPP-4i.
- Los SGLT2i se asociaron con un uso reducido de glucocorticoides a dosis altas (RR 0.78), AINE (RR 0.85), colchicina (RR 0.87) y diuréticos (RR 0.87).
- Estas asociaciones fueron más pronunciadas en pacientes que usaban diuréticos al inicio y persistieron en análisis secundarios.
Conclusiones:
- Los inhibidores de SGLT2 pueden disminuir la necesidad de medicamentos relacionados con la gota en pacientes con gota y diabetes tipo 2.
- La reducción del uso de medicamentos podría mitigar los riesgos asociados con los AINE y los glucocorticoides en esta población de alto riesgo.
- Se justifica una mayor investigación sobre los beneficios cardiovasculares-renales-metabólicos de los SGLT2i en pacientes con gota.
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