The risk of latent tuberculosis infection in patients with type 2 diabetes mellitus according to the use of sodium-glucose cotransporter 2 inhibitors: A national database cohort study.

OBJECTIVES

Latent tuberculosis infection (LTBI) is still a potential infectious threat and is associated with a high risk to active TB. We studied the influence of sodium-glucose cotransporter 2 inhibitors (SGLT2-i) on the risk of LTBI in patients with diabetes mellitus (DM).

METHODS

We retrospectively recruited patients with newly-diagnosed DM from the National Health Insurance database from 2017 to 2020. The risk of LTBI in patients with DM and the use of SGLT2-i were analyzed.

RESULTS

During the study period, a total of 846,691 patients with new type II DM were chosen. We classified patients with the use of SGLT2-i (n = 90,611) and matched a two-fold cohort of 181,222 patients without use of SGLT2-i (n = 181,222) using a propensity-score method. The percentages of LTBI in SGLT2-i users and non-SGLT2-i users were 0.24% and 0.45%, respectively. The adjusted hazard ratio (aHR) of LTBI was significantly lower in patients with low-dose SGLT2-i use (0.69 [0.53-0.91], P = 0.0072) and those with high-dose SGLT2-i use (0.33 [0.24-0.47], P <0.0001) than in the non-SGLT2-i group.

CONCLUSIONS

SGLT2-i might reduce the risk of LTBI in patients with new-onset DM in a dose-response manner. Although validation of this possibility is needed, using SGLT2-i in patients with DM might be considered in the absence of contraindications.