Effects of sodium‐glucose co‐transporter 2 (SGLT2) inhibitors on serum uric acid level: A meta‐analysis of randomized controlled trials

To describe the effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM), PubMed, CENTRAL, EMBASE, and ClinicalTrials.gov were searched for randomized controlled trials of SGLT2 inhibitors in patients with T2DM up to 20 May 2017. Sixty-two studies totaling 34,941 patients were included. Either SGLT2 inhibitor (empagliflozin, canagliflozin, dapagliflozin, tofogliflozin, luseogliflozin or ipragliflozin) significantly decreased SUA levels compared with control (total WMD −37.73 µmol/L, 95% CI [−40.51, −34.95]). Treatment with empagliflozin resulted in a superior reduction in SUA (WMD −45.83 µmol/L, 95% CI [−53.03, −38.63]). The effect persisted for long-term treatment duration. Dapagliflozin decreased SUA in a dose-dependent manner (from 5 mg to 50 mg, p = 0.014). In subgroup analyses, greater reductions could be observed in early diabetes course and the SUA-lowering effect was abolished in patients with chronic kidney disease (estimated glomerular filtration rate less than 60 mL per min per 1.73 m2). The drug class effect of SUA reduction suggesting SGLT2 inhibitors might be beneficial for diabetic patients with hyperuricemia.