Risk of lower extremity amputations in people with type 2 diabetes mellitus treated with sodium‐glucose co‐transporter‐2 inhibitors in the USA: A retrospective cohort study

Sep 13, 2017Diabetes, obesity & metabolism

Risk of leg amputations in people with type 2 diabetes treated with SGLT2 inhibitors in the USA

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Abstract

The incidence rate of below-knee lower extremity amputation was 1.18 events per 1000 person-years for new users of canagliflozin.

  • Among 118,018 new users of SGLT2 inhibitors, including 73,024 on canagliflozin, the incidence rates of BKLE amputation were 1.22 for SGLT2 inhibitors, 1.26 for canagliflozin, and 1.87 for non-SGLT2 inhibitor antihyperglycaemic agents.
  • In a matched comparison of 63,845 users each of canagliflozin and non-SGLT2 inhibitor AHAs, the incidence rates of BKLE amputation were 1.18 and 1.12 events per 1000 person-years, respectively.
  • The hazard ratio for BKLE amputation between canagliflozin and non-SGLT2 inhibitor AHAs was 0.98, indicating no significant difference in risk.
  • P values and calibrated P values showed no evidence of increased risk of BKLE amputation associated with canagliflozin use compared to non-SGLT2 inhibitor AHAs.

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Key numbers

1.22 per 1000 person-years
Crude Incidence Rate of BKLE Amputation (SGLT2 inhibitors)
Incidence rate for patients using SGLT2 inhibitors.
1.26 per 1000 person-years
Crude Incidence Rate of BKLE Amputation (Canagliflozin)
Incidence rate for patients using canagliflozin.
0.98
Hazard Ratio for BKLE Amputation (Canagliflozin vs. Non-SGLT2 AHAs)
Comparative analysis of amputation risk between canagliflozin and non-SGLT2 inhibitors.

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