New study spotlights a link between blockbuster SGLT2 drugs and potentially lethal gangrene
A new study in the Annals of Internal Medicine highlights an apparent connection between the new wave of SGLT2 diabetes drugs and extremely rare cases of flesh-eating bacteria called Fournier gangrene that attacks the genital and rectal areas of patients.
Researchers tracked 55 cases of necrotizing fasciitis over 6 years leading up to January 31, 2019. All of these incidents were flagged by the FDA’s Adverse Event Reporting System. Thirty-nine of the victims were men, the rest women. Several of the patients required surgery while three died and two others required amputations to stop the attack.
The cases were broken down by which of these popular diabetes drugs they were on. J&J’s Invokana — which comes with a black box warning of an increased risk of amputations — had the largest group at 21, followed by 18 cases among patients taking Eli Lilly’s blockbuster Jardiance and 16 using AstraZeneca’s Farxiga. The more recently approved Steglatro didn’t make the list.
The researchers discounted the likelihood of a chance link with the SGLT2 drugs, according to a report in WebMD, noting that they could find only 19 other cases of Fournier gangrene among patients taking any other kind of diabetes medication over the past 35 years.
“This is the first attempt to gain some data on the frequency with which this happens [with the SGLT2 inhibitor drugs]. This is a very aggressive infection, and infection tends to be more aggressive in diabetics,” says Baylor’s Alan J. Garber, who reviewed the study.