An analysis of the effectiveness and safety of ipragliflozin for glucocorticoid-induced hyperglycemia in patients with autoimmune diseases

Abstract

［Objective］ To investigate the effectiveness and safety of ipragliflozin in glucocorticoid-induced hyperglycemia in patients with autoimmune diseases. ［Methods］ We retrospectively examined HbA1c levels and adverse events after initiation of ipragliflozin treatment for glucocorticoid-induced hyperglycemia in patients with autoimmune diseases who were followed up for 24 weeks at our hospital between 2015 and 2021. ［Results］ Among the 39 patients on ipragliflozin, 8 discontinued it because of insufficient effects and adverse events. The remaining 31 patients（rheumatoid arthritis 22, systemic lupus erythematosus 4, others 6; 21females and 10 males, median age 68.0 years old）were followed up for 24 weeks on ipragliflozin. At 24 weeks, the HbA1c value was significantly reduced（7.6［7.3, 8.3］to 7.2［6.5, 8.0］, p=0.008）, even though the prednisolone（PSL）dose was significantly reduced（6.0［2.3, 7.9］mg/day to 5.0［2.3, 6.3］mg/day, p<0.001）. In 11 patients receiving a fixed or increased dose of PSL and fixed antidiabetic drugs, HbA1c values were also significantly reduced（7.5［7.3, 7.9］to 7.2［6.8, 7.7］, p=0.024）. No serious adverse effects were observed. ［Conclusions］ In the short term, ipragliflozin is an effective and safe treatment for glucocorticoid-induced hyperglycemia in patients with autoimmune diseases.