Association between sodium–glucose co‐transporter 2 inhibitors and risk of psoriasis in patients with diabetes mellitus: a nationwide population‐based cohort study

• Published in: Clinical and experimental dermatology Vol. 47; no. 12; pp. 2242 - 2250
• Main Authors: Ma, Sheng‐Hsiang, Wu, Chun‐Ying, Lyu, Ying‐Syuan, Chou, Yiing‐Jenq, Chang, Yun‐Ting, Wu, Chen‐Yi
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-12-2022
• Subjects: Cirrhosis; Cohort analysis; Comorbidity; Diabetes; Diabetes mellitus (non-insulin dependent); Glucose transporter; Inflammasomes; Inflammation; Insulin; Liver cirrhosis; Liver diseases; Patients; Population studies; Population-based studies; Psoriasis; Pyrin protein; Sex ratio
• ISSN: 0307-6938; 1365-2230
• DOI: 10.1111/ced.15385

Background
Sodium–glucose co‐transporter 2 inhibitor (SGLT2i) treatment may exert anti‐inflammatory effects by modulating the NOD‐like receptor family pyrin domain‐containing 3 inflammasome and interleukin‐17/23 inflammatory axis, which are both involved in the pathogenesis of psoriasis. However, the relationship between SGLT2i treatment and psoriasis remains unclear.
Aim
To investigate the association between SGLT2i treatment and incident psoriasis.
Methods
Using the Taiwan National Health Insurance Database for the period 2007–2018, we matched 103 745 patients with Type 2 diabetes mellitus (T2DM) receiving SGLT2i with a control group of patients with T2DM who did not use SGLT2i, matching them in a 1 : 2 ratio by age, sex, diabetes duration, insulin use and comorbidities, and evaluating the psoriasis risk in both groups.
Results
The incident psoriasis risk did not significantly differ between the SGLT2i and control groups [hazard ratio (HR) = 1.24, 95% CI 0.95–1.64] after adjustment for potential confounders. Insulin use (HR = 1.65, 95% CI 1.24–2.19) and chronic liver disease and cirrhosis (HR = 1.34, 95% CI 1.01–1.77) were significantly associated with increased psoriasis risk. A slightly increased psoriasis risk was also detected in certain SGLT2i user subgroups, especially those with renal disease (HR = 2.73, 95% CI 1.45–5.13).
Conclusion
SGLT2i‐mediated protective effects in psoriasis could not be established. SGLT2i treatment increased psoriasis risk by 2.7‐fold in patients with T2DM exhibiting renal diseases.
In this study, we assessed the effects on psoriasis of sodium‐glucose co‐transporter 2 inhibitor (SGLT2i) treatment in patients who also had diabetes. We did not find any protective effect of SGLT2i treatment on psoriasis. In fact, we found that SGLT2i treatment increased the risk of psoriasis by 2.7‐fold in patients with diabetes with renal diseases.