Effects of #SGLT-2 inhibitors on serum #uric acid in patients with T2DM: A systematic review and network meta-analysis

The present study aims to determine the effects of sodium-glucose cotransporter 2 (SGLT-2) inhibitors on the serum uric acid (SUA) levels of patients with type 2 diabetes mellitus (T2DM) in Asia.

Methods
PubMed, CENTRAL, Embase and Cochrane Library databases were searched for randomized controlled trials (RCTs) of SGLT-2 inhibitors in patients with T2DM up to July 15, 2021, without language or date restrictions.

Results
A total of 19 studies (4218 participants) with high quality were included in the present network meta-analysis. All of the included SGLT-2 inhibitors (empagliflozin, dapagliflozin, canagliflozin, ipragliflozin, luseogliflozin and tofogliflozin) significantly decreased SUA levels compared with those of the control (total standard mean difference [SMD] -0.965, 95% CI [−1.029, −0.901], P = 0.000, I2 = 98.7%) in patients with T2DM. Subgroup analysis and meta-regression showed that the combined analysis of different inhibitors may lead to heterogeneity of the results.

Therefore, among the SGLT-2 inhibitors, the results of the subsequent network meta-analysis revealed that luseogliflozin and dapagliflozin ranked the highest in terms of lowering SUA level among the SGLT-2 inhibitors. Moreover, the network meta-analysis declared that luseogliflozin (1 mg and 10 mg) and dapagliflozin (5 mg) led to a superior reduction in SUA in patients with T2DM.

Conclusions
SGLT-2 inhibitors could significantly reduce SUA levels in patients with T2DM, especially luseogliflozin (1 mg and 10 mg) and dapagliflozin (5 mg) possess the best effects. Therefore, SGLT-2 inhibitors look extremely promising as an anti-diabetes treatment option in patients with T2DM with high SUA.

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