Effects of SGLT2 inhibitors on gout-related and cardiometabolic outcomes in patients with type 2 diabetes mellitus: a scoping review

Abstract Background This review aimed to map the effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on gout-related and cardiometabolic outcomes in patients with type 2 diabetes mellitus (T2DM) and gout. Methods A scoping review was conducted following the Joanna Briggs Institute methodology and the PRISMA-ScR checklist. Searches were performed in PubMed, EMBASE, Scopus, Web of Science, LILACS/BVS, and gray literature sources. Eligible studies included patients with T2DM and gout treated with SGLT2i, assessing outcomes such as mortality, gout flares, serum uric acid (SUA) levels, emergency care visits, and hospitalizations due to gout. The PRISMA-ScR checklist is provided in Additional file 1, and the full search strategy in Additional file 2. Results Of 282 articles initially identified, 22 met the inclusion criteria. Most studies were retrospective cohort studies ( n = 12) or post hoc analyses ( n = 8). Only three studies evaluated patients with both T2DM and gout exclusively. The main findings included reductions in SUA levels ( n = 8), incidence of gout ( n = 12), gout flares ( n = 8), initiation of urate-lowering therapy or colchicine ( n = 8), and gout-related emergency care or hospital visits ( n = 1). Reductions in all-cause ( n = 5) and cardiovascular (CV) mortality ( n = 4) were also reported. Across the included studies, SGLT2i were frequently associated with favorable effects on the analyzed outcomes. Conclusion SGLT2i appears to be associated with multiple favorable effects in patients with T2DM and gout, including urate-lowering effects, reduced gout flares, and lower mortality (all-cause and CV-related). Although limited by the small number of studies focusing specifically on this population, these findings support the potential therapeutic relevance of SGLT2i in patients with coexisting T2DM and gout, contributing to the management of both conditions and the reduction of CV-related events associated with them.