Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;23(1):263-269.
doi: 10.1111/dom.14203. Epub 2020 Oct 19.

Sodium-glucose co-transporter-2 inhibitors and susceptibility to COVID-19: A population-based retrospective cohort study

Christopher Sainsbury  1   2 , Jingya Wang  1 , Krishna Gokhale  1 , Dionisio Acosta-Mena  3 , Samir Dhalla  4 , Nathan Byne  3 , Joht Singh Chandan  1 , Astha Anand  1 , Jennifer Cooper  1 , Kelvin Okoth  1 , Anuradhaa Subramanian  1 , Mansoor N Bangash  5   6 , Thomas Taverner  1 , Wasim Hanif  7 , Sandip Ghosh  7 , Parth Narendran  7   8 , Kar K Cheng  1 , Tom Marshall  1 , Georgios Gkoutos  8 , Konstantinos Toulis  1 , Neil Thomas  1 , Abd Tahrani  7   8   9 , Nicola J Adderley  1 , Shamil Haroon  1 , Krishnarajah Nirantharakumar  1   9   10
Affiliations

Sodium-glucose co-transporter-2 inhibitors and susceptibility to COVID-19: A population-based retrospective cohort study

Christopher Sainsbury et al. Diabetes Obes Metab. 2021 Jan.

Abstract

Sodium-glucose co-transporter-2 (SGLT2) inhibitors are widely prescribed in people with type 2 diabetes. We aimed to investigate whether SGLT2 inhibitor prescription is associated with COVID-19, when compared with an active comparator. We performed a propensity-score-matched cohort study with active comparators and a negative control outcome in a large UK-based primary care dataset. Participants prescribed SGLT2 inhibitors (n = 9948) and a comparator group prescribed dipeptidyl peptidase-4 (DPP-4) inhibitors (n = 14 917) were followed up from January 30 to July 27, 2020. The primary outcome was confirmed or clinically suspected COVID-19. The incidence rate of COVID-19 was 19.7/1000 person-years among users of SGLT2 inhibitors and 24.7/1000 person-years among propensity-score-matched users of DPP-4 inhibitors. The adjusted hazard ratio was 0.92 (95% confidence interval 0.66 to 1.29), and there was no evidence of residual confounding in the negative control analysis. We did not observe an increased risk of COVID-19 in primary care amongst those prescribed SGLT2 inhibitors compared to DPP-4 inhibitors, suggesting that clinicians may safely use these agents in the everyday care of people with type 2 diabetes during the COVID-19 pandemic.

Keywords: DPP-4 inhibitor; SGLT2 inhibitor; antidiabetic drug; pharmaco-epidemiology; type 2 diabetes.

PubMed Disclaimer

Conflict of interest statement

A.S., G.N.T., and K.N. have received funding from AstraZeneca (RSBD20464) unrelated to this manuscript. W.H. reports personal fees and non‐financial support from Novo Nordisk, Eli Lilly, Astra‐ Zeneca, Boehringer Ingelheim and NAPP. A.A.T. reports personal fees and non‐financial support from Novo Nordisk, Eli Lilly, AstraZeneca and Boehringer Ingelheim, personal fees from Janssen, and non‐financial support from Impeto Medical, ResMed and Aptiva. K.N. reports fees from Sanofi, MSD and Boehringer Ingelheim outside the submitted work. K.T reports fees from Sanofi and AstraZeneca. P.N reports fees from Eli Lilly. The other authors (C.S., J.W., K.G., D.A., S.D., N.B., J.S.C., A.A., J.C., K.O., M.B., T.T., S.G., K.K.C., T.M., G.G., N.J.A. and S.H.) report no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Forest plot showing hazard ratios (HRs) for suspected/confirmed COVID‐19 in individuals prescribed sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors compared to those prescirbed dipeptidyl peptidase‐4 (DPP‐4) inhibitors. CI, confidence interval
See this image and copyright information in PMC

References

    1. The OpenSAFELY Collaborative . OpenSAFELY: factors associated with COVID‐19‐related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv preprint 2020.
    1. Barron E, Bakhai C, Kar P, et al. Associations of type 1 and type 2 diabetes with COVID‐19‐related mortality in England: a whole‐population study. The Lancet Diabetes & Endocrinology. 2020;8(10):813–822. 10.1016/s2213-8587(20)30272-2. - DOI - PMC - PubMed
    1. Shi Q, Zhang X, Jiang F, et al. Clinical characteristics and risk factors for mortality of COVID‐19 patients with diabetes in Wuhan, China: a two‐center, retrospective study. Diabetes Care. 2020;43:1382‐1391. - PubMed
    1. Chen Y, Yang D, Cheng B, et al. Clinical Characteristics and Outcomes of Patients With Diabetes and COVID‐19 in Association With Glucose‐Lowering Medication. Diabetes Care. 2020;43(7):1399–1407. 10.2337/dc20-0660. - DOI - PubMed
    1. Verma S, McMurray JJV. SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state‐of‐the‐art review. Diabetologia. 2018;61(10):2108‐2117. - PubMed

Publication types

Substances