{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:29:56Z","timestamp":1785544196689,"version":"3.56.0"},"reference-count":52,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K23-AR081425"],"award-info":[{"award-number":["K23-AR081425"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P50-AR-060772"],"award-info":[{"award-number":["P50-AR-060772"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R00-AR080243"],"award-info":[{"award-number":["R00-AR080243"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR065944"],"award-info":[{"award-number":["R01 AR065944"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["Fellowship Award"],"award-info":[{"award-number":["Fellowship Award"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["THC-135235"],"award-info":[{"award-number":["THC-135235"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Sodium\u2013glucose cotransporter 2 inhibitors (SGLT2is) lower serum urate and are associated with a lower risk of recurrent gout flares. We used target trial emulation to compare rates of allopurinol initiation and use of anti-inflammatories (high-dose glucocorticoids, nonsteroidal anti-inflammatory drugs [NSAIDs], colchicine) and diuretics (prototypic serum urate-raising medication) among patients with gout using SGLT2is versus dipeptidyl peptidase 4 inhibitors (DPP-4is) (primary comparator), with glucagon-like peptide 1 receptor agonists (GLP-1RAs) as an alternative comparator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>From a general population database, we identified patients with gout and comorbid type 2 diabetes and used Cox proportional hazards and Poisson regressions with inverse probability of treatment weighting to emulate randomization to SGLT2i or DPP-4i\/GLP-1RA. We also replicated the analysis in an electronic health record data set with further adjustment for serum urate and BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 26,739 adults with gout and type 2 diabetes (mean age 66 years), 67% had polypharmacy. Allopurinol initiation was lower among SGLT2i initiators than DPP-4i, with a hazard ratio of 0.62 (95% CI 0.52\u20130.73). Associations were stronger among those using diuretics at baseline (P for interaction = 0.03) and persisted when comparing SGLT2i with GLP-1RA and accounting for serum urate and BMI in the secondary data set. SGLT2i was also associated with lower rates of high-dose glucocorticoid, NSAID, colchicine, and diuretic dispensing, with rate ratios of 0.78 (95% CI 0.74\u20130.83), 0.85 (95% CI 0.80\u20130.92), 0.87 (95% CI 0.83\u20130.92), and 0.87 (95% CI 0.85\u20130.89), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>For patients with gout and type 2 diabetes, SGLT2is may reduce gout-related medication use, which could, in turn, reduce exposure to the harmful cardiovascular-kidney-metabolic effects of NSAIDs and glucocorticoids in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-1713","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T16:02:00Z","timestamp":1769788920000},"page":"460-470","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":2,"title":["Gout-Related Medication Use After Initiating Sodium\u2013Glucose Cotransporter 2 Inhibitors in Patients With Gout and Type 2 Diabetes: Population-Based Target Trial Emulation Studies"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4147-8348","authenticated-orcid":false,"given":"Natalie","family":"McCormick","sequence":"first","affiliation":[{"name":"Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology 1 , Massachusetts General Hospital, Boston, MA"},{"name":"The Mongan Institute, Department of Medicine, Massachusetts General Hospital 2 , Boston, MA"},{"name":"Department of Medicine, Harvard Medical School 3 , Boston, MA"},{"name":"Arthritis Research Canada, Vancouver, British Columbia 4 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6926-8505","authenticated-orcid":false,"given":"Nitzan","family":"Burrack","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Soroka University Medical Center 5 , Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chio","family":"Yokose","sequence":"additional","affiliation":[{"name":"Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology 1 , Massachusetts General Hospital, Boston, MA"},{"name":"The Mongan Institute, Department of Medicine, Massachusetts General Hospital 2 , Boston, MA"},{"name":"Department of Medicine, Harvard Medical School 3 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Lu","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada, Vancouver, British Columbia 4 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6979-402X","authenticated-orcid":false,"given":"Deborah J.","family":"Wexler","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School 3 , Boston, MA"},{"name":"Diabetes Center, Massachusetts General Hospital 6 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharan K.","family":"Rai","sequence":"additional","affiliation":[{"name":"Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology 1 , Massachusetts General Hospital, Boston, MA"},{"name":"The Mongan Institute, Department of Medicine, Massachusetts General Hospital 2 , Boston, MA"},{"name":"Department of Medicine, Harvard Medical School 3 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Challener","sequence":"additional","affiliation":[{"name":"Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology 1 , Massachusetts General Hospital, Boston, MA"},{"name":"The Mongan Institute, Department of Medicine, Massachusetts General Hospital 2 , Boston, MA"},{"name":"Department of Medicine, Harvard Medical School 3 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Antonio","family":"Avi\u00f1a-Zubieta","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada, Vancouver, British Columbia 4 , Canada"},{"name":"Division of Rheumatology, Department of Medicine, The University of British Columbia 7 , Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2289-3183","authenticated-orcid":false,"given":"Rozalina G.","family":"McCoy","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine 8 , Baltimore, MD"},{"name":"University of Maryland Institute for Health Computing 9 , North Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7031-6498","authenticated-orcid":false,"given":"Ran","family":"Abuhasira","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Soroka University 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