People living with diabetes with sodium-glucose cotransporter-2 inhibitors use are at an increased risk of future total knee joint replacement.

INTRODUCTION

This study aims to investigate the association between sodium-glucose cotransporter-2 inhibitors (SGLT2I) use and the risk of total knee joint replacement (TKR) among patients with type 2 diabetes mellitus (T2D).

METHODS

282311 T2D patients who used SGLT2I and 282311 T2D patients who did not use SGLT2I were included. Univariable and multivariable Cox proportion hazards regression models were used to examine the effect of risk factors on the risk of developing total knee replacement, presented as a hazard ratio (HR) with a 95% confidence interval (CI). The multivariable models were adjusted for gender, age, diabetes complications severity index (DCSI), comorbidities, and anti-diabetic drugs.

RESULTS

After adjusting for potential confounders, SGLT2I users had a significantly higher risk of undergoing TKR compared to non- SGLT2I users (adjusted HR = 1.33; 95% CI: 1.25-1.42; p < 0.001). The incidence rate of TKR was 2.93 per 1000 person-years for SGLT2I users and 2.33 per 1000 person-years for non- SGLT2I users, respectively.

CONCLUSION

In our study, patients with T2D with SGLT2I use exhibited a significantly higher risk of TKR compared to the DM population without SGLT2I.