11/12/2025
According to a new study published in The BMJ, sodium-glucose cotransporter-2 (SGLT-2) inhibitors may moderately reduce the risk of developing autoimmune rheumatic diseases, such as rheumatoid arthritis, lupus, and spondyloarthritis.
Researchers analyzed data from more than two million adults with type 2 diabetes in South Korea between 2012 and 2022. They compared people who started SGLT-2 inhibitors, a newer yet increasingly common type of diabetes medication, with people who used sulfonylureas, an older class of drugs.
After detailed statistical analyses, researchers found that patients taking SGLT-2 inhibitors had about an 11% lower risk of being diagnosed with an autoimmune rheumatic disease. This lower risk remained consistent despite variables such as sex, body weight, and cardiovascular health. The risk was about 21% lower when SGLT-2 inhibitors were compared with another common diabetes drug, DPP-4 inhibitors.
The researchers tested the reliability of the findings in several ways. For example, they used multiple statistical methods to ensure that the results weren’t dependent on just one method. They also varied how they defined “ongoing treatment”, looking at whether patients were considered continuously on the medication if they refilled their prescriptions within 30, 60, or 90 days after their last supply ran out. In addition, they focused on patients who had only taken metformin before starting SGLT-2 inhibitors. Across all these sensitivity analyses, the lower risk remained consistent.
Overall, the results suggest that SGLT-2 inhibitors may have anti-inflammatory or immune-modulating effects that could lower the risk of autoimmune disease. According to the study, this makes sense given that SGLT-2 inhibitors have been shown in preclinical studies to reduce pro-inflammatory cytokines, modulate immune cell activity, and improve insulin sensitivity and fat distribution, all of which could help lower autoimmune risk. However, the authors of the study emphasize that more research is needed to confirm these findings and to understand whether the same benefits apply to people who already have autoimmune conditions.
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