UNASSIGNED: To investigate whether the use of SGLT2is is associated with the onset and progression of lupus nephritis and other kidney and cardiac outcomes in patients with SLE and type 2 diabetes.
UNASSIGNED: This multicenter cohort study used the US Collaborative Network of the TriNetX clinical data platform to identify patients with SLE and type 2 diabetes from January 1, 2015, to December 31, 2022. Data collection and analysis were conducted in September 2023.
UNASSIGNED: Individuals were categorized into 2 groups by SGLT2i use or nonuse with 1:1 propensity score matching.
UNASSIGNED: The Kaplan-Meier method and Cox proportional hazards regression models were used to calculate the 5-year adjusted hazard ratios (AHRs) of lupus nephritis, dialysis, kidney transplant, heart failure, and mortality for the 2 groups.
UNASSIGNED: From 31 790 eligible participants, 1775 matched pairs of SGLT2i users and nonusers (N = 3550) were selected based on propensity scores. The mean (SD) age of matched participants was 56.8 (11.6) years, and 3012 (84.8%) were women. SGLT2i users had a significantly lower risk of lupus nephritis (AHR, 0.55; 95% CI, 0.40-0.77), dialysis (AHR, 0.29; 95% CI, 0.17-0.48), kidney transplant (AHR, 0.14; 95% CI, 0.03-0.62), heart failure (AHR, 0.65; 95% CI, 0.53-0.78), and all-cause mortality (AHR, 0.35; 95% CI, 0.26-0.47) than SGLT2i nonusers.
UNASSIGNED: In this cohort study of patients with SLE and type 2 diabetes, SGLT2i users had a significantly lower risk of lupus nephritis, dialysis, kidney transplant, heart failure, and all-cause mortality than nonusers. The findings suggest that SGLT2is may provide some nephroprotective and cardioprotective benefits.
■研究SGLT2is的使用是否与SLE和2型糖尿病患者的狼疮性肾炎的发作和进展以及其他肾脏和心脏结果相关。
■这项多中心队列研究使用TriNetX临床数据平台的美国协作网络从2015年1月1日至2022年12月31日识别SLE和2型糖尿病患者。数据收集和分析于2023年9月进行。
■根据SGLT2i的使用或不使用,将个体分为2组,1:1倾向评分匹配。
■使用Kaplan-Meier方法和Cox比例风险回归模型来计算狼疮性肾炎的5年调整风险比(AHR),透析,肾移植,心力衰竭,两组的死亡率。
■来自31790名符合条件的参与者,根据倾向评分选择了1775对匹配的SGLT2i用户和非用户(N=3550)。匹配参与者的平均年龄(SD)为56.8(11.6)岁,女性为3012人(84.8%)。SGLT2i使用者患狼疮性肾炎的风险显著降低(AHR,0.55;95%CI,0.40-0.77),透析(AHR,0.29;95%CI,0.17-0.48),肾移植(AHR,0.14;95%CI,0.03-0.62),心力衰竭(AHR,0.65;95%CI,0.53-0.78),和全因死亡率(AHR,0.35;95%CI,0.26-0.47)比SGLT2i非用户。
■在这项SLE和2型糖尿病患者的队列研究中,SGLT2i使用者患狼疮性肾炎的风险明显降低,透析,肾移植,心力衰竭,和全因死亡率比非使用者。研究结果表明,SGLT2is可能提供一些肾保护和心脏保护益处。