Gout incidence in metformin versus sodium–glucose co-transporter-2 inhibitor users: a retrospective cohort study
Authors' conclusion
Gout risk may be comparable between metformin and SGLT-2is in individuals with diabetes, with metformin showing a lesser reduction in serum uric acid levels than SGLT-2is.
Study context
- Population
- Adults with diabetes in the JMDC claims database with health check-up and administrative claims data, 2014–2022 (17,636 males; mean age 53 years)
- Participants
- 21,561 adults
- Exposure
- Metformin initiation vs SGLT-2i initiation
- Metforminn = 13,535
- SGLT-2in = 8,026reference
- Outcome
- Incidence of new gout diagnoses
Methodological detailsnew-user comparative effectiveness, propensity-score inverse probability treatment weighting (IPTW), Cox proportional hazards models
- New-user comparative effectiveness
- Propensity-score IPTW
- Cox proportional hazards models
Main finding
As reported in the abstract
New gout diagnoses
Each group vs SGLT-2iHazard ratio (95% CI)
Metformin
0.90(0.63–1.28)
Each group vs SGLT-2iRate difference, events per 1000 person-years (95% CI)
Metformin
−0.28(−1.24 to 0.68)
Observational data: associations, not effects.
Further findings
| Outcome | Mean difference (mg/dl) (95% CI) | |
|---|---|---|
| Change in serum uric acid level · 1 year after the index dateLinear mixed model | 0.48 (0.43–0.52) | |
| −0.500.51Difference, mg/dl (linear scale) |
Original publication
Gout incidence in metformin versus sodium–glucose co-transporter-2 inhibitor users: a retrospective cohort study. Rheumatology (Oxford). Published 24 March 2025. doi:10.
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