Do SGLT-2 Inhibitors Cause Severe UTIs?

Sodium-–glucose cotransporter-2 (SGLT-2) inhibitors (e.g., canagliflozin [Invokana], dapagliflozin [Farxiga], empagliflozin [Jardiance]) inhibit glucose reabsorption in renal tubules and increase urinary glucose excretion. Some reports, including meta-analyses of randomized trials, suggest that this effect might be associated with excess risk for urinary tract infections (UTIs). Since 2015, the U.S. FDA has required SGLT-2 inhibitors' prescribing information to carry a warning about risk for severe UTIs.

Investigators used two large U.S. insurance databases to conduct a propensity-adjusted analysis comparing SGLT-2 inhibitors with dipeptidyl peptidase-4 (DPP-4) inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists in >235,000 patie…