{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:02:01Z","timestamp":1790892121033,"version":"4.1.0"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Recurrent flares are the hallmark of clinical manifestation of gout. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been associated with a lower risk of incident gout; however, their association with recurrent flares is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the association of SGLT2i vs active comparators (ie, glucagonlike peptide-1 receptor agonists [GLP-1 RA] or dipeptidyl peptidase-4 inhibitors [DPP-4i]) with the risk of recurrent gout flares and all-cause mortality among patients with gout and type 2 diabetes.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based retrospective cohort study was performed from January 1, 2013, to March 31, 2022, using a UK primary care database. Participants included patients with gout and type 2 diabetes with visits to their general practitioners.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Initiation of treatment with SGLT2i or active comparators.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was the number of recurrent gout flares ascertained using recorded codes and prescription records. Secondary outcomes were the first recurrent gout flare and all-cause mortality. The association of SGLT2i compared with active comparators for the risk of recurrent flares, the first recurrent flare, and all-cause mortality was assessed using Poisson regression or the Cox proportional hazards model with propensity score overlap weighting.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of a total of 5931 patients included in the analysis (mean [SD] age, 66.0 [11.6] years; 4604 [77.6%] men), 1548 initiated SGLT2i treatment and 4383 initiated treatment with active comparators during the study period. The relative rate of the recurrent flares with SGLT2i vs active comparators was 0.79 (95% CI, 0.65-0.97). Similar results were observed in the association of SGLT2i with the rate of recurrent flares when compared with DPP-4i or GLP-1 RA. For the first recurrent flare for SGLT2i vs active comparators, rate difference was \u22128.8 (95% CI, \u221217.2 to \u22120.4) per 1000 person-years and the hazard ratio was 0.81 (95% CI, 0.65-0.98). All-cause mortality per 1000 person-years was 18.8 for SGLT2i and 24.9 for active comparators, with rate difference of \u22126.1 (95% CI, \u221210.6 to \u22121.6) per 1000 person-years and hazard ratio of 0.71 (95% CI, 0.52-0.97).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this cohort study suggest that SGLT2i were associated with a lower risk of recurrent gout flares and mortality than their active comparators in patients with gout and type 2 diabetes. These findings further suggest that SGLT2i could help reduce the burden of recurrent gout flares and could also narrow the mortality gap between patients with gout and the general population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.30885","type":"journal-article","created":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T11:33:41Z","timestamp":1692963221000},"page":"e2330885","source":"Crossref","is-referenced-by-count":42,"title":["Gout Flares and Mortality After Sodium-Glucose Cotransporter-2 Inhibitor Treatment for Gout and Type 2 Diabetes"],"prefix":"10.1001","volume":"6","author":[{"given":"Jie","family":"Wei","sequence":"first","affiliation":[{"name":"Health Management Center, Xiangya Hospital, Central South University, Changsha, China"},{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China"},{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 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Key Laboratory of Joint Degeneration and Injury, Changsha, China"},{"name":"Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjun","family":"Li","sequence":"additional","affiliation":[{"name":"Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China"},{"name":"Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China"},{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China"},{"name":"Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghua","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China"},{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China"},{"name":"Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston"},{"name":"The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,8,25]]},"reference":[{"issue":"11","key":"zoi230892r1","doi-asserted-by":"publisher","first-page":"1916","DOI":"10.1002\/art.v72.11","article-title":"Prevalence, incidence, and years lived with disability due to gout and its attributable risk factors for 195 countries and territories 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017.","volume":"72","author":"Safiri","year":"2020","journal-title":"Arthritis 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