Evidence map›Paper›PMID 38710868›Full record

ArticleJournal of general internal medicine2024

Empagliflozin and Risk of Incident Gout: Analysis from the EMPagliflozin Comparative Effectiveness and SafEty (EMPRISE) Cohort Study.

Helen Tesfaye, Katherine M Wang, Luke E Zabotka, Deborah J Wexler, Niklas Schmedt, Lisette Koeneman, Leo Seman, Julie M Paik, Elisabetta Patorno

Abstract readComparative Study
In one paragraph

Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Helen TesfayeDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Katherine M WangDivision of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Luke E ZabotkaDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Deborah J WexlerMGH Diabetes Center, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Niklas SchmedtBoehringer Ingelheim International GmbH, Ingelheim, Germany.
Lisette KoenemanLilly Deutschland GmbH, Bad Homburg, Germany.
Leo SemanBoehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, USA.
Julie M PaikDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Elisabetta PatornoDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. epatorno@bwh.harvard.edu.ORCID 0000-0002-8809-9898

Funding

Novel approaches to improve comparative effectiveness research of medical and surgical weight reduction strategies in clinical practiceR01DK138036 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI Elisabetta Patorno · 2024 to 2026
$2.3M
Optimizing the Safety of the Newer Diabetes Medications in Patients with Diabetes and Kidney DiseaseR01DK135706 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI Julie M Paik · 2024 to 2026
$2.2M
Boehringer Ingelheim 116283NIDDK NIH HHS R01 DK135706NIDDK NIH HHS R01 DK138036
6 · The paper itself

Abstract

backgroundHyperuricemia is frequently observed in patients with type 2 diabetes (T2D) and is associated with increased risk of gout and cardiovascular disease (CVD). Empagliflozin lowers serum urate levels by enhancing its urinary excretion.

objectiveTo compare initiators of empagliflozin vs dipeptidyl peptidase-4 inhibitor (DPP4i) and initiators of empagliflozin vs glucagon-like peptide-1 receptor agonist (GLP-1RA) with respect to the risk of incident gout events. DESIGN AND

participantsUsing three claims-based datasets from 08/2014 to 09/2019, we generated two cohorts (cohort 1: empagliflozin vs DPP4i; cohort 2: empagliflozin vs GLP-1RA) of adult patients with T2D and without prior history of gout or gout-specific medication dispensing separately in each dataset. To assess the risk of incident gout, we estimated hazard ratios (HR) and rate differences (RD) per 1000 person-years (PY) with their 95% confidence intervals (CI) before and after 1:1 propensity score (PS) matching adjusting for 141 baseline covariates. KEY

resultsWe identified 102,262 pairs of 1:1 propensity score-matched adults in cohort 1 and 131,216 pairs in cohort 2. Over a mean follow-up period of 8 months on treatment, the risk of gout was lower in patients initiating empagliflozin compared to DPP4i (HR = 0.69: 95% CI (0.60-0.79); RD =  - 2.27: 95% CI (- 3.08, 1.46)) or GLP-1RA (HR = 0.83: 95% CI (0.73-0.94); RD =  - 0.99: 95% CI (- 1.66, - 0.32)). Results were consistent across subgroups (sex, age, body mass index, chronic kidney disease, heart failure, cardiovascular disease, and concurrent diuretic use) and sensitivity analyses.

conclusionsAmong adults with T2D, the initiation of empagliflozin vs a DPP4i or GLP-1RA was associated with lower risk of incident gout, complementing results from a post hoc analysis of the EMPA-REG OUTCOME trial and previously published observational research focusing on the sodium-glucose co-transporter-2 inhibitor class in more narrowly defined study populations.

Indexed as

Benzhydryl CompoundsDiabetes Mellitus, Type 2GlucosidesGoutSodium-Glucose Transporter 2 InhibitorsAdultAgedCohort StudiesComparative Effectiveness ResearchDipeptidyl-Peptidase IV InhibitorsFemaleHumansIncidenceMaleMiddle AgedBenzhydryl CompoundsDipeptidyl-Peptidase IV InhibitorsempagliflozinGlucosidesSodium-Glucose Transporter 2 Inhibitorsempagliflozinincident gouttype 2 diabetes mellitus

Identifiers

PMID38710868
PMCPMC11282041

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.