Empagliflozin Linked to Higher Short-Term UTI Risk Than Dapagliflozin: Study
Empagliflozin was associated with a higher short-term incidence of urinary tract infections (UTIs) compared with dapagliflozin, despite similar metabolic outcomes. The findings support monitoring for UTIs in patients receiving SGLT2 inhibitors, particularly those prescribed empagliflozin. The study was published in the International Journal of Endocrinology and Metabolism by Sara K. and colleagues.
To test the incidence rate of UTIs, the study authors utilized a randomized, double-blinded trial of 149 patients of both type 1 and type 2 diabetes mellitus, aged 18 years and above. The study participants were randomized to either be under treatment for 3 months with dapagliflozin 5 mg per day (79 patients) or with empagliflozin 10 mg per day (70 patients). The variables including fasting blood sugar (FBS), glycated hemoglobin (HbA1c), and serum creatinine (Cr) were meticulously obtained before and after the treatment period of 3 months. UTI was detected systematically by laboratory analysis of urine and midstream urine culture. Analysis was performed using SPSS v28.0; significance was set at P < 0.05.
Key findings:
- Quantitative synthesis of trial outcomes across the 149 enrolled participants (mean age 62.7 ± 9.7 years; balanced baseline characteristics) yielded specific comparative safety and efficacy metrics over 3 months.
- Confirmed urinary tract infections occurred in 12 out of 149 total participants (8.1%) during the 3-month study period.
- Among the 79 women treated with dapagliflozin 5 mg daily, 2 patients (2.5%) developed a confirmed UTI.
- Among the 70 women treated with empagliflozin 10 mg daily, 10 patients (14.3%) developed a confirmed UTI.
- Dapagliflozin demonstrated a significantly lower odds of UTI compared to empagliflozin (OR = 0.16; 95% CI, 0.03–0.74; P = 0.009).
- No statistically significant intergroup differences were observed in post-treatment changes for fasting blood sugar (FBS), glycated hemoglobin (HbA1c), or serum creatinine (Cr) levels.
The study results suggest that there is an increased incidence of short-term UTIs in women suffering from diabetes on empirical treatment with empagliflozin, compared to dapagliflozin without compromising its effectiveness on glycemic control and renal function. Conclusions drawn from the study imply that active UTI surveillance and tailored drug choice should be considered while initiating SGLT2 inhibitors, especially empagliflozin.
Reference:
Kazem-Nadi S, Keshtkari S, Labbani-Motlagh Z, Mousavi V. Comparative Incidence of Urinary Tract Infections in Diabetic Women Treated with Dapagliflozin Versus Empagliflozin: A Double-Blind Randomized Clinical Trial. Int J Endocrinol Metab. 2026;24(4):e168824. doi: https://doi.org/10.5812/ijem-168824
