Sodium glucose co-transporter 2 ( SGLT2 ) inhibitors reduce serum urate levels. In a post hoc analysis researchers have investigated the effect of Canagliflozin ( Invokana ) compared to placebo on gout in the CANagliflozin cardioVascular Assessment Study ( CANVAS ) Program.
The CANVAS Program randomly assigned 10,142 participants with type 2 diabetes to Canagliflozin or placebo.
Patients with an adverse event attributed to gout or the need for commencement of a drug for gout were identified and the effects of Canagliflozin compared to placebo were estimated by calculating the hazard ratio ( HR ) and 95% confidence interval ( 95% CI ).
Mean serum urate levels at baseline were 348.2 ( standard deviation 94.3 ) micromol/L in the Canagliflozin group and 349.8 ( 97.1 ) micromol/L in the placebo group.
Serum urate levels were on average 23.3 micromol/L ( 95% CI: -25.4 to -21.3 ) lower in those treated with Canagliflozin compared to placebo during follow-up.
There were 70 individuals who reported an episode of gout and 147 who required commencement of a drug for gout.
The occurrence of gout or the need for treatment for gout was lower in those treated with Canagliflozin compared to placebo ( HR 0.52 95% CI: 0.38 to 0.69 ).
The separate HR for the effect on the risk of gout was 0.58 ( 95% CI: 0.36 to 0.94 ) and for the effect on the need for treatment for gout was 0.52 ( 95% CI: 0.38 to 0.72 ).
In conclusion, Canagliflozin has reduced serum urate levels and the risk of adverse events attributed to gout. ( Xagena )
Source: 55th Annual Meeting of the European Association for the Study of Diabetes ( EASD ), 2019