Mp10-04 use of sodium-glucose cotransporter (sglt2) inhibitors in diabetic stone formers is associated with a reduced risk of future stone events

You have accessJournal of UrologyCME1 Apr 2023MP10-04 USE OF SODIUM-GLUCOSE COTRANSPORTER (SGLT2) INHIBITORS IN DIABETIC STONE FORMERS IS ASSOCIATED WITH A REDUCED RISK OF FUTURE STONE EVENTS Ridwan Alam, Jared Winoker, Naren Nimmagadda, and Brian Matlaga Ridwan AlamRidwan Alam More articles by this author , Jared WinokerJared Winoker More articles by this author , Naren NimmagaddaNaren Nimmagadda More articles by this author , and Brian MatlagaBrian Matlaga More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003225.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have emerged as a treatment for diabetes mellitus with additional cardiovascular and renal benefits over other classes of antihyperglycemics. Promising data suggests that SGLT2i may also reduce the risk of urolithiasis. We compared the risk of urolithiasis among diabetic patients with a history of stones prescribed SGLT2i versus other antihyperglycemics. METHODS: TriNetX is a collaborative research enterprise with real-time data from over 70 healthcare organizations with more than 100 million patients. We queried the database for adult patients presenting between 1/1/2016 and 1/1/2021 with type 2 diabetes mellitus and a prior history of urolithiasis. Patients receiving SGLT2i therapy were compared against two groups: (1) patients receiving dipeptidyl peptidase 4 (DPP-4i) or glucagon-like peptide-1 receptor agonist (GLP-1-RA) and (2) all patients not receiving SGLT2i. Propensity score matching was performed to control for confounding. The risk of urolithiasis was compared at 1, 3, and 5 years after initiation of therapy, and Kaplan-Meier analysis was used to determine freedom from a stone event. RESULTS: Among diabetics with a history of stones, SGLT2i was prescribed to 3,576 patients, DPP-4i or GLP-1-RA to 17,952 patients, and any non-SGLT2i to 131,592 patients. After matching, each group contained 3,572 patients. The cumulative incidence of urolithiasis in patients prescribed SGLT2i was 24.0% at 1 year, 33.8% at 3 years, and 35.9% at 5 years. In comparison, the risk of urolithiasis was approximately 20% higher at each timepoint when patients were prescribed DPP-4i or GLP-1-RA, or any non-SGLT2i therapy (Table 1). As such, patients taking SGLT2i demonstrated the highest rates of freedom from a stone event over the course of 5 years (p<0.001) (Figure 1). CONCLUSIONS: When managing diabetic patients with a history of stones, the use of SGLT2i presents an attractive option due to the significantly decreased risk of future stone events when compared to other antihyperglycemic medications. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e115 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ridwan Alam More articles by this author Jared Winoker More articles by this author Naren Nimmagadda More articles by this author Brian Matlaga More articles by this author Expand All Advertisement PDF downloadLoading ...