Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the newest class of oral diabetes medications. There are concerns of an increased risk of genitourinary infections based on trial data, however this risk at a population level is understudied. We conducted a population-based study using linked administrative databases in Ontario of women and men with diabetes over the age of 66 who were incident users of SGLT2i from Jan-Dec 2016. We quantified the association between SGLT2i and each of genital mycotic infection and urinary tract infection within 30 days of drug initiation using a retrospective cohort design. The comparator group were new users of a DPP-4i. We identified 21,444 incident SGLT2i users and 22,463 DPP-4i users. Among SGLT2i users, 41% were women and the mean age at index was 71.8 ± 5 years. After adjusting for propensity score, age, sex, and recent UTI, there was a 2.47 fold increased risk of a genital mycotic infection with SGLT2i (adjusted hazard ratio (HR), 2.47; 95% CI 2.08-2.92, p < 0.001) within 30 days. For UTI, the adjusted HR was 0.89 (95% CI 0.78-1.00, p=0.05) overall. Incident SGLT2i use among older women and men is associated with an increased risk of genital mycotic infections within 30 days; there is no associated increased risk of UTI. These findings from a real-world setting provide evidence of the potential harms of SGLT2i.
I.C. Lega: None. S. Bronskill: None. M.A. Campitelli: None. J. Guan: None. N.M. Stall: None. K. Lam: None. L.M. McCarthy: None. A. Gruneir: None. P.A. Rochon: None.
Canadian Institutes of Health Research (PJT153060)