Gout is a painful form of arthritis caused by high levels of uric acid in the blood. When too much uric acid builds up, it can form crystals in the joints, leading to swelling, redness, and severe pain.
In the U.S., over 12 million adults have gout, and it is especially common in people aged 65 or older.
Gout doesn’t just affect joints—it is often seen in people who also have heart problems, kidney disease, and type 2 diabetes.
To help prevent painful gout flares, doctors often prescribe medications called urate-lowering therapies (ULTs).
However, these drugs don’t treat other health problems that people with gout may have. This means patients often end up taking several different kinds of medicine, which increases the number of pills they take and raises the risk of side effects or drug interactions.
Recently, a group of researchers led by Dr. Natalie McCormick at Massachusetts General Hospital looked at a class of diabetes drugs called SGLT2 inhibitors.
These drugs are already used to treat type 2 diabetes, heart failure, and kidney disease. Interestingly, they also lower uric acid levels and reduce the need for diuretics, which are medications that can trigger gout attacks.
The researchers wanted to know: could using SGLT2 inhibitors help people with both gout and type 2 diabetes lower their risk of flare-ups and reduce their need for gout medications?
To find out, they used health records from over 18,000 adults with both conditions. All had recently started taking a new glucose-lowering drug but weren’t yet on urate-lowering treatments.
They compared three groups: people taking SGLT2 inhibitors, those taking DPP-4 inhibitors, and those taking GLP1 receptor agonists. The researchers used advanced statistics to make the groups as similar as possible, mimicking the setup of a clinical trial. Then they watched to see which patients ended up needing gout medications and how often they had flares.
The results were promising. People taking SGLT2 inhibitors were 38% less likely to start using allopurinol, a common gout medication.
They also had fewer prescriptions for pain drugs like NSAIDs, colchicine, and steroids—medications often used to treat flare-ups. In addition, they had fewer gout flares and needed fewer diuretics, especially the stronger ones like loop diuretics.
These findings were consistent even when the researchers tested the data in different ways and with another large dataset. The results suggest that SGLT2 inhibitors might be a better choice for people with both gout and type 2 diabetes.
This could be great news for patients and doctors. Using SGLT2 inhibitors may help simplify treatment plans, reduce side effects from pain medications, and improve quality of life for people living with multiple chronic health problems.
Dr. McCormick and her team say that this study also opened their eyes to the problem of polypharmacy—when patients have to take five or more medications regularly.
This is common in people with gout, but not well studied. In the future, McCormick hopes to explore how to reduce the medication burden for people with this condition.
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The study is published in Diabetes Care.
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