Reduction seen in recurrent nephrolithiasis events for those receiving SGLT-2 inhibitors versus GLP-1 RAs, DPP-4 inhibitors
TUESDAY, Nov. 12, 2024 (HealthDay News) — For patients with nephrolithiasis, sodium-glucose cotransporter-2 (SGLT-2) inhibitor use is associated with a reduction in recurrence, according to a study published online Oct. 30 in The BMJ.
Natalie McCormick, Ph.D., from Massachusetts General Hospital in Boston, and colleagues emulated target trials comparing recurrence of nephrolithiasis among patients with preexisting nephrolithiasis initiating SGLT-2 inhibitors versus an active comparator. A total of 20,146 patients with nephrolithiasis and type 2 diabetes, including those with gout at baseline, initiated an SGLT-2 inhibitor or glucagon-like peptide-1 receptor agonist (GLP-1 RA), with a dipeptidyl peptidase-4 (DPP-4) inhibitor as an alternative comparator.
After inverse probability of treatment weighting, the researchers identified 1,924 recurrent nephrolithiasis events among 14,456 weighted patients who used an SGLT-2 inhibitor compared with 853 events among the 5,877 patients who used a GLP-1 RA (105.3 versus 156.4 per 1,000 person-years). The adjusted rate ratio was 0.67 and rate difference was −51 per 1,000 person-years. The absolute rate difference was 219 per 1,000 person-years among those with recently active nephrolithiasis. For nephrolithiasis events that required emergency department visits, hospital admissions, or procedures and when an SGLT-2 inhibitor was compared with a DPP-4 inhibitor, the protective associations persisted. Among patients with nephrolithiasis and concomitant gout, the protective associations also persisted (rate ratios, 0.67 and 0.63; rate differences, −53 and −62 per 1,000 person-years) compared with GLP-1 RAs and DPP-4 inhibitors, respectively.
“This class of drugs may be a useful addition to the current treatments for nephrolithiasis to simultaneously tackle the high burden of kidney stones and comorbidities, including gout,” the authors write.
Several authors disclosed ties to industry.
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