Trends in Clinical Characteristics and Prescribing Preferences for SGLT2 Inhibitors and GLP-1 Receptor Agonists, 2013-2018
- 1 April 2020
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 43 (4), 921-924
- https://doi.org/10.2337/dc19-1943
Abstract
OBJECTIVE There is a paucity of data evaluating recent changes in clinical and prescriber characteristics of patients initiating sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA). RESEARCH DESIGN AND METHODS U.S.-based administrative claims data (July 2013 to June 2018) were used to identify initiators of SGLT2i and GLP-1RA. RESULTS Over 5 years, empagliflozin initiation (as a proportion of SGLT2i) increased by 57.1% (P < 0.001 for trend), while canagliflozin initiation declined by 75.1% (P < 0.001). Empagliflozin was the only agent within SGLT2i with an increase in the proportion of patients with myocardial infarction, stroke, or heart failure (collectively called CVD-HF) (P < 0.001). Liraglutide initiation (as a proportion of total GLP-1RA) declined by 32.1% (P < 0.001), and dulaglutide initiation increased by 34.1% (P < 0.001); the proportion of patients with CVD-HF increased the most in liraglutide initiators (5.1% increase; P < 0.001). Most prescribers were internists or endocrinologists; cardiologist prescribing remained low (<1%). CONCLUSIONS For SGLT2i, shifts in preference for empagliflozin followed changes in drug labels and guidelines, while for GLP-1RA, other factors such as price or ease of administration may have led to a preference for dulaglutide over liraglutide.This publication has 9 references indexed in Scilit:
- SUN-149 Cardiologist vs. Endocrinologist Encounters in Patients with T2D and CVD: Potential Implications for Glucose-Lowering Therapy Use and EducationJournal of the Endocrine Society, 2019
- Prescription of Glucagon-Like Peptide-1 Receptor Agonists by CardiologistsJournal of the American College of Cardiology, 2019
- 2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular DiseaseJournal of the American College of Cardiology, 2018
- Prescriber Patterns of SGLT2i After Expansions of U.S. Food and Drug Administration LabelingJournal of the American College of Cardiology, 2018
- Canagliflozin and Cardiovascular and Renal Events in Type 2 DiabetesThe New England Journal of Medicine, 2017
- Empagliflozin and Progression of Kidney Disease in Type 2 DiabetesThe New England Journal of Medicine, 2016
- Liraglutide and Cardiovascular Outcomes in Type 2 DiabetesThe New England Journal of Medicine, 2016
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)The Lancet, 1998
- Role of diabetes in congestive heart failure: The Framingham studyThe American Journal of Cardiology, 1974