Effects of empagliflozin on serum uric acid level of patients with type 2 diabetes mellitus: a systematic review and meta‐analysis

BACKGROUND: Serum uric acid levels are higher in patients with type 2 diabetes and prediabetes compared to healthy individuals, and hyperuricemia causes a significant rate of complications and mortality through heart and kidney diseases. Accordingly, the present systematic review and meta-analysis aimed to investigate the effect of empagliflozin on serum uric acid levels. MATERIALS AND METHODS: Electronic databases, including PubMed, Scopus, Web of Science, Cochrane, and Google Scholar, were used to search papers until May 22, 2023. Data analysis was conducted by STATA Version 14, and P-value < 0.05 were considered statistically significant. RESULTS: The results obtained from the combination of 12 studies with 7801 samples of diabetic patients indicated that in the empagliflozin group, the serum uric acid levels of the patients decreased ([standardized mean difference (SMD): − 1.97 (95%CI − 3.39, − 0.55)], Systolic blood pressure (SBP) [SMD: − 2.62 (95%CI − 3.87, − 1.37)] and diastolic blood pressure (DBP) [SMD: − 0.49 (95%CI − 0.68, − 0.29)]). On the other side, empagliflozin treatment did not affect the patients’ HbA1c levels ([SMD: − 2.85 (95%CI − 6.14, 0.45)], eGFR [SMD: 0.78 (95%CI − 0.63, 2.18)], creatinine [SMD:0.11 (95%CI − 0.10, 0.31)], LDL [SMD: 0.14 (95%CI − 0.43, 0.71)], and HDL [SMD:1.38 (95%CI − 0.22, 2.99)]). Compared with the placebo, empagliflozin was more effective in reducing the uric acid levels ([SMD: − 1.34 (95%CI − 2.05, − 0.63)], SBP [SMD: − 2.11 (95%CI − 3.89, − 0.33)], and HbA1c [SMD: − 1.04 (95%CI − 1.95, − 0.13)]). Moreover, compared with sitagliptin also, empagliflozin was more effective in reducing uric acid levels ([SMD: − 1 (95%CI − 1.78, − 0.22)], and creatinine [SMD: − 1.60 (95%CI − 2.28, − 0.92)]) and increasing eGFR levels [SMD: 0.99 (95%CI: 0.37, 1.62)] of the patients. Compared with dapagliflozin also, empagliflozin caused a reduction in eGFR level [SMD: − 0.45 (95%CI − 0.82, − 0.08)]. CONCLUSION: Empagliflozin treatment was effective in controlling diabetic patients’ hyperuricemia and hypertension. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13098-023-01182-y.