Authorea Preprints
SGLT2 inhibitors and reduced risk of gout in type 2 diabetes: a systematic review and multilevel meta-analysis of real-world evidence
By Felici FD and D’Agnese S.
Abstract
Aims
To assess the association between SGLT2 inhibitors (SGLT2i) and the risk of gout-related events in patients with type 2 diabetes (T2DM), compared with DPP4i and GLP-1 receptor agonists (GLP-1-RA), whilst taking into account the interdependence between estimates from the same study.
Methods
A systematic review (PRISMA 2020; PROSPERO CRD420261455053) of PubMed/MEDLINE and Scopus up to July 2026, including real-world new-user cohorts and active comparators. The estimates were synthesised using a three-level random-effects model (cohorts nested within studies) and compared with a model assuming independence. Risk of bias: ROBINS-I; certainty: GRADE.