Prescribing Patterns of SGLT2 inhibitors and GLP-1 receptor agonists in
Patients with T2DM and ASCVD in South Korea
Abstract
Background: Despite cardiovascular benefits of sodium-glucose
cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor
agonists (GLP1RA) in patients with type 2 diabetes mellitus (T2DM) and
atherosclerotic cardiovascular disease (ASCVD), their utilization
remains low globally. This study aimed to evaluate the utilization of
SGLT2i and GLP1RA in patients with T2DM and ASCVD, as well as the
factors associated with medications in South Korea. Methods:
This retrospective study was conducted from 2015 to 2020, using National
Patient Sample claims data. The study population included adult patients
with confirmed T2DM and ASCVD diagnosed between March 1 and October 31
each year. Demographic and clinical characteristics, and influencing
factors were investigated. Results: Among 57,576 study
participants, SGLT2i use increased from 1.2 % to 10.51 % during the
study period, whereas GLP1RA use increased slightly from 0 % to 1.17
%. Older age, comorbid chronic kidney disease, concurrent use of
dipeptidyl peptidase 4 inhibitors (DPP4i), and prescriptions from
specific physician specialties negatively influenced SGLT2i use.
Conversely, comorbid dyslipidemia, heart failure, concurrent use of
sulfonylurea (SU), and prescriptions from cardiologists positively
influenced SGLT2i use. For GLP1RA, older age, concurrent DPP4i use, and
specific physician specialty were negative factors, whereas female sex,
dyslipidemia, insulin, and SU use were positive factors.
Conclusions: Despite increasing utilization, 88.35 % of
eligible patients remained untreated with SGLT2i and GLP1RA as of 2020.
This study highlights the disparities in utilization based on patient
characteristics and physician specialties, emphasizing the need to
remove barriers and enhance clinical benefits for high-risk patients.