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Diabetes Obes Metab. 2020 Feb;22(2):267-271. doi: 10.1111/dom.13886. Epub 2019 Oct 13.

Fournier's gangrene in patients with type 2 diabetes using second-line antidiabetic medications.

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Science, Aetion, Inc, New York, New York.
Division of Pharmacoepidemiology, Department of Medicine and Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Pharmacy Strategy and Clinical Integration, Horizon Healthcare Services Inc., Newark, New Jersey.
School of Pharmacy, Rutgers State University of New Jersey, New Brunswick, New Jersey.


Cases of a rare but serious infection called Fournier's gangrene have been reported with sodium-glucose co-transporter-2 inhibitors (SGLT-2i). To evaluate the safety signal in a population of patients with type 2 diabetes, we used administrative claims data from Horizon Blue Cross Blue Shield of New Jersey from 2014 through 2017 to estimate incidence rates of Fournier's gangrene or necrotizing fasciitis of the perineum among patients treated with a second-line antidiabetic drug. We found very low incidence rates of Fournier's gangrene or necrotizing fasciitis. While we found no indication of an increased risk among SGLT-2i users compared with similar patients treated with other second-line antidiabetic medications, the small number of events yielded wide confidence intervals.


cohort study; database research; observational study; pharmaco-epidemiology; sodium-glucose co-transporter-2 inhibitor; type 2 diabetes


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