Genitourinary Tract Infections in Patients Taking SGLT2 Inhibitors: JACC Review Topic of the Week

J Am Coll Cardiol. 2024 Apr 23;83(16):1568-1578. doi: 10.1016/j.jacc.2024.01.040.

Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been shown to reduce adverse cardiovascular events in patients with type 2 diabetes mellitus, all-cause mortality, and heart failure hospitalization in patients with heart failure, as well as adverse renal outcomes. However, concerns regarding the heightened risk of genitourinary (GU) infections, particularly urinary tract infections, remain a significant barrier to their wider adoption. Addressing these misconceptions using existing evidence is needed to ensure proper risk-benefit assessment and optimal utilization of this efficacious therapy. This review aims to provide a balanced perspective on the evidence-based cardiovascular and renal benefits of SGLT2is and the associated risk of GU infections. We also summarize and propose clinical practice considerations for SGLT2i-associated GU infections focusing on patients with cardiovascular disease.

Keywords: SGLT2 inhibitors; diabetes; heart failure; urinary tract infection; urogenital infection.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases* / etiology
  • Diabetes Mellitus, Type 2* / complications
  • Heart Failure* / drug therapy
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use
  • Urinary Tract Infections* / chemically induced
  • Urinary Tract Infections* / complications
  • Urinary Tract Infections* / drug therapy

Substances

  • Sodium-Glucose Transporter 2 Inhibitors
  • Hypoglycemic Agents