Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysis
Although SGLT2 inhibitors have been initially employed in the treatment of type 2 diabetes, their clinical use was later extended to the treatment of other conditions such as heart failure, chronic kidney disease and obesity. In patients with type 2 diabetes, the administration of SGLT2 inhibitors...
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PAGEPress Publications
2023-06-01
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| Series: | Archivio Italiano di Urologia e Andrologia |
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| Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/11509 |
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| author | Rawa Bapir Kamran Hassan Bhatti Ahmed Eliwa Herney Andrés García-Perdomo Nazim Gherabi Derek Hennessey Vittorio Magri Panagiotis Mourmouris Adama Ouattara Gianpaolo Perletti Joseph Philipraj Konstantinos Stamatiou Musliu Adetola Tolani Lazaros Tzelves Stefan D. Anker Alberto Trinchieri Noor Buchholz |
| author_facet | Rawa Bapir Kamran Hassan Bhatti Ahmed Eliwa Herney Andrés García-Perdomo Nazim Gherabi Derek Hennessey Vittorio Magri Panagiotis Mourmouris Adama Ouattara Gianpaolo Perletti Joseph Philipraj Konstantinos Stamatiou Musliu Adetola Tolani Lazaros Tzelves Stefan D. Anker Alberto Trinchieri Noor Buchholz |
| author_sort | Rawa Bapir |
| collection | DOAJ |
| description |
Although SGLT2 inhibitors have been initially employed in the treatment of type 2 diabetes, their clinical use was later extended to the treatment of other conditions such as heart failure, chronic kidney disease and obesity. In patients with type 2 diabetes, the administration of SGLT2 inhibitors has been associated with an increased incidence of urogenital infections, which may be linked to high glucose levels in the urine. The rate of urogenital side effects may be different in non-diabetic patients. The aim of this study was to review the risk of urogenital infections in non-diabetic patients taking SGLT2 inhibitors. Materials and methods: We conducted a systematic review and meta-analysis by searching PubMed and EMBASE for randomized controlled trials (RCTs) reporting urogenital adverse effects in non-diabetic patients treated with SGLT2 inhibitors. Odds ratios for urogenital infections were calculated using random effect Mantel-Haenszel statistics. Results: Out of 387 citations retrieved, 12 eligible RCTs were assessed for risk of bias and included in the meta-analysis. Compared to placebo, SGLT2 inhibitors were associated with increased odds of genital infections (OR 3.01, 95% CI: 1.93- 4.68, 9 series, 7326 participants, Z = 5.74, p < 0.0001, I2 = 0%) as well as urinary tract infections (OR 1.33, 95% CI: 1.13-1.57, 9 series, 7326 participants, Z = 4.05, p < 0.0001, I2 = 0%). When four trials investigating the effects of SGLT2 inhibitors in populations including both diabetic and non-diabetic patients were considered, administration of SGLT2 inhibitors in diabetic patients was associated with significantly higher odds of genital infections but not urinary tract infections compared to patients without type 2 diabetes. In patients taking placebo, the odds for urinary tract infections were significantly increased in diabetic patients compared to non-diabetic patients. Conclusions: The risk of genital infections is increased also in non-diabetic patients taking SGLT2 inhibitors although at a lesser extent that in diabetics. A careful assessment of the local anatomical conditions and of the history of previous urogenital infections is desirable to select those patients who need more intense follow-up, possibly combined with prophylactic measures of infections during treatment with SGLT2 inhibitors.
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| first_indexed | 2024-03-13T05:32:04Z |
| format | Article |
| id | doaj.art-fb4e096b234d4efa84b454e7b8190c7d |
| institution | Directory Open Access Journal |
| issn | 1124-3562 2282-4197 |
| language | English |
| last_indexed | 2024-03-13T05:32:04Z |
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| series | Archivio Italiano di Urologia e Andrologia |
| spelling | doaj.art-fb4e096b234d4efa84b454e7b8190c7d2023-06-14T22:50:37ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972023-06-0195210.4081/aiua.2023.11509Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysisRawa Bapir0Kamran Hassan Bhatti1Ahmed Eliwa2Herney Andrés García-Perdomo3Nazim Gherabi4Derek Hennessey5Vittorio Magri6Panagiotis Mourmouris7Adama Ouattara8Gianpaolo Perletti9Joseph Philipraj10Konstantinos Stamatiou11Musliu Adetola Tolani12Lazaros Tzelves13Stefan D. Anker14Alberto Trinchieri15Noor Buchholz16U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Smart Health Tower, Sulaymaniyah, Kurdistan regionU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology Department, HMC, Hamad Medical CorporationU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Zagazig University, Zagazig, SharkiaU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Universidad del Valle, CaliU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Faculty of Medicine Algiers 1, AlgiersU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Mercy University Hospital, CorkU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology Unit, ASST Fatebenefratelli Sacco, MilanU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, AthensU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Division of Urology, Souro Sanou University Teaching Hospital, Bobo-DioulassoU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, VareseU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, PuducherryU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Tzaneio General Hospital, 18536 PiraeusU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Division of Urology, Department of Surgery, Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria, Kaduna StateU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, AthensDepartment of Cardiology and BCRT (Campus CVK), Charité Universitätsmedizin BerlinU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology School, University of Milan, MilanU-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Sobeh's Vascular and Medical Center, Dubai Health Care City, Dubai Although SGLT2 inhibitors have been initially employed in the treatment of type 2 diabetes, their clinical use was later extended to the treatment of other conditions such as heart failure, chronic kidney disease and obesity. In patients with type 2 diabetes, the administration of SGLT2 inhibitors has been associated with an increased incidence of urogenital infections, which may be linked to high glucose levels in the urine. The rate of urogenital side effects may be different in non-diabetic patients. The aim of this study was to review the risk of urogenital infections in non-diabetic patients taking SGLT2 inhibitors. Materials and methods: We conducted a systematic review and meta-analysis by searching PubMed and EMBASE for randomized controlled trials (RCTs) reporting urogenital adverse effects in non-diabetic patients treated with SGLT2 inhibitors. Odds ratios for urogenital infections were calculated using random effect Mantel-Haenszel statistics. Results: Out of 387 citations retrieved, 12 eligible RCTs were assessed for risk of bias and included in the meta-analysis. Compared to placebo, SGLT2 inhibitors were associated with increased odds of genital infections (OR 3.01, 95% CI: 1.93- 4.68, 9 series, 7326 participants, Z = 5.74, p < 0.0001, I2 = 0%) as well as urinary tract infections (OR 1.33, 95% CI: 1.13-1.57, 9 series, 7326 participants, Z = 4.05, p < 0.0001, I2 = 0%). When four trials investigating the effects of SGLT2 inhibitors in populations including both diabetic and non-diabetic patients were considered, administration of SGLT2 inhibitors in diabetic patients was associated with significantly higher odds of genital infections but not urinary tract infections compared to patients without type 2 diabetes. In patients taking placebo, the odds for urinary tract infections were significantly increased in diabetic patients compared to non-diabetic patients. Conclusions: The risk of genital infections is increased also in non-diabetic patients taking SGLT2 inhibitors although at a lesser extent that in diabetics. A careful assessment of the local anatomical conditions and of the history of previous urogenital infections is desirable to select those patients who need more intense follow-up, possibly combined with prophylactic measures of infections during treatment with SGLT2 inhibitors. https://www.pagepressjournals.org/index.php/aiua/article/view/11509Sodium glucose transporter 2 (SGLT2) inhibitorsUrinary tract infectionsGenital infectionsCandidiasisHeart failureChronic kidney disease |
| spellingShingle | Rawa Bapir Kamran Hassan Bhatti Ahmed Eliwa Herney Andrés García-Perdomo Nazim Gherabi Derek Hennessey Vittorio Magri Panagiotis Mourmouris Adama Ouattara Gianpaolo Perletti Joseph Philipraj Konstantinos Stamatiou Musliu Adetola Tolani Lazaros Tzelves Stefan D. Anker Alberto Trinchieri Noor Buchholz Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysis Archivio Italiano di Urologia e Andrologia Sodium glucose transporter 2 (SGLT2) inhibitors Urinary tract infections Genital infections Candidiasis Heart failure Chronic kidney disease |
| title | Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysis |
| title_full | Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysis |
| title_fullStr | Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysis |
| title_full_unstemmed | Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysis |
| title_short | Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysis |
| title_sort | risk of urogenital infections in non diabetic patients treated with sodium glucose transporter 2 sglt2 inhibitors systematic review and meta analysis |
| topic | Sodium glucose transporter 2 (SGLT2) inhibitors Urinary tract infections Genital infections Candidiasis Heart failure Chronic kidney disease |
| url | https://www.pagepressjournals.org/index.php/aiua/article/view/11509 |
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