在患有痛风和2型糖尿病的患者中启动-葡萄糖共运输体2抑制剂后,与痛风相关的药物使用:基于人口的向试验仿真研究
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
概括
-葡萄糖共运输体2抑制剂 (SGLT2is) 可能会降低2型糖尿病患者的痛风药物需求. 这一发现表明SGLT2is可以减少常见痛风治疗的不良影响.
科学领域:
- 心血管和代谢科学 心血管和代谢科学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 类风湿病学 类风湿病学
背景情况:
- 已知-葡萄糖共运输体2抑制剂 (SGLT2is) 可以降低血清尿酸盐水平.
- 而SGLT2与经常性痛风爆发的风险降低有关.
- 痛风患者经常有并发症,如2型糖尿病和多药.
研究的目的:
- 为了比较SGLT2抑制剂和其他糖尿病药物之间的药物开始和用于痛风管理的使用.
- 为了评估在SGLT2is治疗的患者中使用阿洛普林醇,抗炎药物 (葡萄皮质类药物,NSAID,素) 和利尿剂与二二酶4抑制剂 (DPP-4is) 或类似葡萄糖类1受体激活剂 (GLP-1RAs) 的使用.
主要方法:
- 目标试验仿真与一般人口数据库一起使用.
- 应用了Cox比例危险和Poisson回归与治疗权重的逆概率.
- 该分析在电子健康记录数据集中复制,调整了血清尿酸和BMI.
主要成果:
- 与DPP-4i使用者相比,SGLT2i启动者表现出较低的阿洛普林醇启动率 (HR 0.62).
- SGLT2is与高剂量的葡萄皮质类药物 (RR 0.78),NSAID (RR 0.85),胆固醇 (RR 0.87),和利尿剂 (RR 0.87) 的使用减少有关.
- 这些关联在基线使用利尿剂的患者中更为明显,并在二次分析中持续存在.
结论:
- 在患有痛风和2型糖尿病的患者中,SGLT2抑制剂可能会降低对痛风相关药物的需求.
- 减少药物的使用可以减轻与这种高风险人群中NSAID和葡萄皮质类药物相关的风险.
- 需要进一步研究SGLT2is在痛风患者的心血管--代谢益处.
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