Concomitant Use of Sodium‐Glucose Cotransporter 2 Inhibitors and Overactive Bladder Drugs and the Risk of Urinary Tract Infection

Jan 29, 2024Clinical pharmacology and therapeutics

Using Diabetes and Overactive Bladder Drugs Together and the Risk of Urinary Tract Infection

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Abstract

In a cohort of 796 new users of SGLT-2 inhibitors, the risk of urinary tract infections was found to be similar to that of 9,181 users of DPP-4 inhibitors while taking overactive bladder drugs.

Concomitant use of SGLT-2 inhibitors and overactive bladder drugs does not appear to increase the risk of urinary tract infections compared to DPP-4 inhibitors.
The weighted hazard ratio for urinary tract infections in SGLT-2i users was 1.08, indicating no significant difference in risk from DPP-4i users.
Among 2,387 new users of SGLT-2 inhibitors compared to 280 users of GLP-1 receptor agonists, there was no increased risk of urinary tract infections associated with SGLT-2i use.
The findings suggest that initiating SGLT-2 inhibitors while on overactive bladder treatment is not linked to a higher incidence of urinary tract infections.

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Concomitant use of sodium glucose cotransporter-2 inhibitors (SGLT-2i) and overactive bladder (OAB) drugs potentially poses a risk of urinary tract infections (UTIs) due to the urinary retention of highly concentrated glucose in the urine. Thus, this study aimed to investigate the risk of UTIs among patients who initiated SGLT-2i treatment while taking OAB drugs. This population-based cohort study included new-users of SGLT-2i or comparator antidiabetics (dipeptidyl peptidase-4 inhibitor (DPP-4i); glucagon-like peptide-1 receptor agonist (GLP-1RA)) with OAB drugs between 2014 and 2020 using claim data from Korea. Primary outcome was a composite UTI event composite end point comprising pyelonephritis, cystitis, and urethritis, using both inpatient and outpatient diagnoses. Propensity score fine stratification was used to adjust for potential confounding factors. Weighted hazard ratios (HR) were calculated using the Cox proportional hazards model. In the first cohort, 796 and 9,181 new-users of SGLT-2i and DPP-4i with OAB drugs were identified, respectively. This study found a similar risk of UTIs in concomitant users of SGLT-2i and DPP-4i (weighted HR 1.08, 95% confidence interval: 0.88-1.32) with OAB drugs. In the second cohort, 2,387 and 280 new-users of SGLT-2i and GLP-1RA with OAB drugs were identified, respectively. Initiation of SGLT-2i while on OAB treatment was not associated with increased risk of UTI (0.89, 0.50-1.60), compared with initiation of GLP-1RA. These results show that the concomitant use of SGLT-2i with OAB drugs was not associated with an increased risk of UTI compared with the concomitant use of DPP-4i or GLP-1RA with OAB drugs.

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Concomitant Use of Sodium‐Glucose Cotransporter 2 Inhibitors and Overactive Bladder Drugs and the Risk of Urinary Tract Infection

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