https://orcid.org/0000-0003-3811-6503
We thank the authors for their thoughtful comments on our paper [Citation1]. We agree with the authors that the differential effects of both the duration and dose of sodium-glucose cotransporter-2 inhibitors (SGLT2is) should be evaluated in future trials.
Saijo et al. [Citation2] observed in their study in Japan that urinary tract infections (UTIs) were one of the most common (7%) reasons for discontinuing SGLT2is, and these infections were mostly observed to occur after 3 months of therapy. It would be valuable to closely monitor the incidence and impact of UTIs in large-scale post-marketing surveillance studies involving substantial patient populations.
Additionally, future meta-analyses evaluating these outcomes should incorporate trial sequential analysis to confirm the adequacy of the available evidence [Citation3]. This statistical technique can help determine whether the cumulative evidence is sufficient to draw reliable conclusions, or if further research is needed.
Considering the potential clinical significance of UTIs associated with SGLT2is, we believe that a comprehensive assessment of their incidence, timing, and impact on treatment adherence and outcomes is warranted. Rigorous real-world evidence, as well as thorough meta-analytical approaches, can provide important insights to guide clinical decision-making and optimize the safe use of this medication class.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
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References
- Sridharan K, Sivaramakrishnan G. Genito-urinary infectious adverse events related to sodium glucose cotransporter-2 inhibitors: a network meta-analysis and meta-regression. Expert Rev Clin Pharmacol. 2024 May;17(5–6):515–524. doi: 10.1080/17512433.2024.2355287
- Saijo Y, Okada H, Hata S, et al. Reasons for discontinuing treatment with sodium-glucose cotransporter 2 inhibitors in patients with diabetes in real-world settings: the KAMOGAWA-A study. J Clin Med. 2023;12(22):6993. doi: 10.3390/jcm12226993
- Kang H. Trial sequential analysis: novel approach for meta-analysis. Anesth Pain Med (Seoul). 2021 Apr;16(2):138–150. doi: 10.17085/apm.21038