Evidence mapPaperPMID 39885375Full record

SynthesisThe Annals of pharmacotherapy2025

Sodium-Glucose Co-Transporter 2 Inhibitors and Severe Urinary Tract Infections: Real-World Meta-Analysis of Cohort Studies.

Mohammed Aboukaoud, Yocheved Morhi, Ester Osher

Abstract readMeta-AnalysisReview
In one paragraph

Synthesis in The Annals of pharmacotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Mohammed AboukaoudDivision of Internal Medicine, Rambam Health Care Campus, Haifa, Israel.ORCID 0000-0001-6991-9523
Yocheved MorhiDivision of Internal Medicine, Rambam Health Care Campus, Haifa, Israel.
Ester OsherFaculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere is limited knowledge about severe urinary tract infections associated with SGLT2i, despite this being the basis for the Food and Drug Administration (FDA) warning. We aim to provide real-world evidence to clarify this relationship further. DATA SOURCE: A literature review was performed in PubMed and Embase for cohort studies published up to August 2024 using PICO-consistent terms. STUDY SELECTION AND DATA EXTRACTION: Cohort studies in English involving new users of SGLT2i that compare SGLT2i with glucagon-like receptor agonists (GLP-1RA), DPP4i, and other glucose-lowering medications and report severe urinary tract infection (UTI). DATA SYNTHESIS: The random-effect model determined the odds ratio (OR) and 95% confidence interval (CI) for severe UTI. Subgroup analysis and meta-regression were used to identify sources of heterogeneity. In 11 cohort studies involving 679 617 individuals with type 2 diabetes mellitus and a median age of 64 (interquartile range [IQR] = 56-72) and 42% (IQR = 39%-51%) females, it was found that the use of SGLT2i was associated with a reduced risk of severe UTI compared with both composite glucose-lowering medications (OR = 0.73, 95% CI = 0.60-0.88) and DPP4i (OR = 0.48, 95% CI = 0.43-0.54). There was no significant difference in the risk compared with GLP-1RA (OR = 0.94, 95% CI = 0.78-1.14). RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: The lack of increased risk for severe UTI reassures physicians when assessing benefit-risk to continue SGLT2i after a severe UTI. This may enhance patient adherence and improve diabetes management. Furthermore, our findings show no significant risk increase in chronic kidney disease (CKD) patients who would benefit significantly from SGLT2i.

conclusionSGLT2i does not appear to pose a greater risk of severe UTI than other oral glucose-lowering medications. This contributes to the existing literature on UTI, accounting for the event's severity. However, more data are needed to assess the potential association between SGLT2i and life-threatening UTI events.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsUrinary Tract InfectionsCohort StudiesFemaleHumansSeverity of Illness IndexHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitorsglucagon-like peptide-1 receptor agonistsglucose-lowering medicationspyelonephritissodium-glucose co-transporter 2urinary tract infectionsurosepsis

Identifiers

PMID39885375
PMCPMC12357981

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.