Certain Diabetes Drugs Linked to Genital Gangrene

Type 2 diabetes drugs in the class known as SGLT2 inhibitors have been linked to an increased risk of developing gangrene of the genital area, a rare but potentially fatal side effect, according to a new report in the Annals of Internal Medicine.

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From March 2013 through January 31, 2019, the U.S. Food and Drug Adminstration received reports of 55 instances of the condition, known as Fournier gangrene, in people taking three medicines in the SGLT2 inhibitor class. The medicines associated with the condition were canagliflozin (brand name Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance). A fourth medicine in the class, ertugliflozin (Steglatro) had no reports of gangrene associated with its use, but this may have been due to its limited time on the U.S. market, according to the authors of the report, having been approved in December 2017.

SGLT2 inhbitors work by blocking the action of the SGLT2 protein in the kidneys that reabsorbs glucose from the blood, allowing the kidneys to excrete more glucose through the urine. Fournier gangrene is known as a “flesh-eating” disease that attacks the genital or anal region, and it can quickly kill tissue.

The researchers emphasized that the risk for Fournier gangrene with use of an SGLT2 inhibitor remains low: “In 2017, an estimated 1.7 million patients received a dispensed prescription for an SGLT2 inhibitor,” noted study author Susan Bersoff-Matcha, MD. So “Fournier gangrene is a rare event… While our study shows an association between treatment with SGLT2 inhibitors and Fournier gangrene, we don’t know exactly what the risk is, or if Fournier gangrene can be predicted.”

Want to learn more about SGLT2 inhibitors? Read “Diabetes Medicine: SGLT2 Inhibitors.”

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