{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:16:39Z","timestamp":1792757799698,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients with systemic lupus erythematosus (SLE) were excluded from sodium\u2013glucose cotransporter 2 inhibitors (SGLT2i) clinical trials. It is unknown whether the cardiorenal benefits of SGLT2i extend to patients with SLE and comorbid type 2 diabetes (T2D).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed an emulated clinical trial in an insurance\u2010based cohort in the United States, evaluating SGLT2i versus dipeptidyl peptidase\u20104 inhibitors (DPP4i) for primary prevention of cardiovascular, renal, and other clinical outcomes among patients with both SLE and comorbid T2D. SGLT2i initiators were matched to DPP4i initiators using propensity scores (PSs) based on clinical and demographic factors. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Outcomes among 2,165 patients starting SGLT2i and 2,165 PS\u2010matched patients starting DPP4i were compared. Over 753.1 (\u00b1479.2) mean days, SGLT2i recipients had significantly lower risks of incident acute kidney injury (HR 0.49, 95% CI 0.39\u20130.63), chronic kidney disease (HR 0.61, 95% CI 0.50\u20130.76), end\u2010stage renal disease (HR 0.40, 95% CI 0.20\u20130.80), heart failure (HR 0.72, 95% CI 0.56\u20130.92), emergency department visits (HR 0.90, 0.82\u20130.99), and severe sepsis (HR 0.61, 95% CI 0.39\u20130.94). Risks of all\u2010cause mortality (HR 0.89, 95% CI 0.65\u20131.21), lupus nephritis (HR 0.67, 95% CI 0.38\u20131.15), myocardial infarction (HR 0.81, 95% CI 0.54\u20131.23), stroke (HR 1.03, 95% CI 0.74\u20131.44), and hospitalizations (HR 0.76, 95% CI 0.51\u20131.12) did not differ. Genital infection risk (HR 1.31, 95% CI 1.07\u20131.61) was increased, but urinary tract infection risk (HR 0.90, 95% CI 0.79\u20131.03) did not differ. No significant difference was observed for diabetic ketoacidosis risk (HR 1.07, 95% CI 0.53\u20132.14) and fractures (HR 0.95, 95% CI 0.66\u20131.36).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this emulated clinical trial, treatment with SGLT2i, compared to DPP4i\u00a0therapy, was associated with significantly reduced risks of several cardiorenal complications among patients with both SLE and T2D.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.43037","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T06:04:08Z","timestamp":1729490648000},"page":"414-422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Efficacy and Safety of Sodium\u2013Glucose Cotransporter 2 Inhibitors for the Primary Prevention of Cardiovascular, Renal Events, and Safety Outcomes in Patients With Systemic Lupus Erythematosus and Comorbid Type 2 Diabetes: A Population\u2010Based Target Trial Emulation"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9394-4144","authenticated-orcid":false,"given":"Kevin Sheng\u2010Kai","family":"Ma","sequence":"first","affiliation":[{"name":"Center for Global Health, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2572-0111","authenticated-orcid":false,"given":"Jui\u2010En","family":"Lo","sequence":"additional","affiliation":[{"name":"Center for Global Health, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7652-3826","authenticated-orcid":false,"given":"Vasileios C.","family":"Kyttaris","sequence":"additional","affiliation":[{"name":"Division of Rheumatology and Clinical Immunology, Department of 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