患有类风湿性关节炎的患者使用SGLT2抑制剂的尿路感染风险:一个向试验仿真研究
Naofumi Dobashi1,2, Ken-Ei Sada1,2, Masataka Kudo1,3,4
1Department of Clinical Epidemiology, Kochi Medical School, Nankoku, Japan.
Rheumatology (Oxford, England)
|November 5, 2025
概括
在患有糖尿病的类风湿性关节炎 (RA) 患者中使用-葡萄糖共传输体-2 抑制剂 (SGLT2i) 可能会增加尿路感染 (UTI) 的风险. 然而,治疗意图分析表明,SGLT2i对于常规临床使用是安全的.
科学领域:
- 类风湿病学 类风湿病学
- 内分泌学 在内分泌学.
- 药物监督 药物监督 药物监督
背景情况:
- 类风湿性关节炎 (RA) 和糖尿病 (DM) 经常同时存在.
- -葡萄糖共运输体-2 抑制剂 (SGLT2i) 越来越多地被用于DM.
- 在RA患者中,SGLT2i的尿路感染 (尿路感染) 的风险尚未得到充分确立.
研究的目的:
- 分析DM的RA患者中SGLT2i处方的趋势.
- 评估SGLT2i使用与该人群中尿路感染风险之间的关联.
- 模拟一个目标试验来评估SGLT2i的安全性.
主要方法:
- 对行政索赔数据库的回顾性分析 (2015年4月至2023年4月).
- 包括年龄≥18岁,患有2型糖尿病的RA患者.
- 分别使用准Poisson和Poisson混合效应模型进行意向治疗 (ITT) 和被处理 (AT) 分析.
主要成果:
- 在患有DM的RA患者中,SGLT2i的处方显著增加.
- 按处理 (AT) 分析显示,SGLT2i使用与尿路感染风险增加之间存在统计学上显著的关联 (aIRR 1.64,95% CI 1.26-2.13).
- 治疗意图 (ITT) 分析显示,尿路感染风险没有显著差异.
结论:
- 在患有DM的RA患者中,SGLT2i的使用可能与尿路感染的风险增加有关.
- ITT分析结果支持SGLT2i选择在临床实践中的一般安全性.
- 对于尿路感染风险,SGLT2i和葡萄糖皮质醇使用之间没有发现显著的相互作用.
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