Abstract
Objectives
Landmark clinical trials have shown the sodium–glucose cotransporter-2 (SGLT-2) inhibitors
to have cardiorenal benefits beyond their glucose-lowering effect. Clinical guidelines
now recommend their use in patients with chronic kidney disease or heart failure,
with or without type 2 diabetes, potentially affecting prescribing patterns among
physician specialties.
Methods
Using monthly projected total retail dispensed prescription data from IQVIA’s CompuScript
database, we assessed trends in prescribing SGLT-2 inhibitors among 6 prescriber specialities
from 2015 to 2021 in Canada. We assessed these trends at the class, agent, and dose
level using joinpoint regression.
Results
From 2015 to 2021, the projected total retail dispensed prescriptions of SGLT-2 inhibitors
from all prescribers increased. Relative to other prescribers, >60% of SGLT-2 inhibitor
prescriptions were written by general practitioners or family physicians. The percentage
of prescriptions from endocrinologists decreased (average annual percent change: mean, −10.8;
95% confidence interval [CI], −12.2% to −9.4%), whereas a dramatic increase was observed
for cardiologists (mean, 44.1%, 95% CI, 32.9 to 56.2). The percentage from nephrologists
also increased, albeit not statistically significant (mean, 12.4; 95% CI, −0.5 to
27.1). Significant changes in the agent and dose of SGLT-2 inhibitor prescribed were
also observed among cardiologists and nephrologists.
Conclusions
Between 2015 and 2021, there was a steady increase in the proportion of SGLT-2 inhibitor
prescriptions from cardiologists and nephrologists, reflecting emerging evidence and
guideline recommendations.
Résumé
Objectifs
Des essais cliniques novateurs ont montré que les inhibiteurs du cotransporteur sodium-glucose
de type 2 (iSGLT2) avaient des bénéfices cardiorénaux qui vont au-delà de leurs effets
hypoglycémiants. Les lignes directrices de pratique clinique recommandent maintenant
leur utilisation chez les patients atteints d’insuffisance rénale chronique ou d’insuffisance
cardiaque, avec ou sans diabète de type 2, ce qui touche potentiellement les habitudes
de prescription des médecins spécialistes.
Méthodes
À partir des données mensuelles sur le nombre total estimé d’ordonnances exécutées
par les pharmacies au détail de la base de données CompuScript d’IQVIA, nous avons
évalué les tendances de prescription des iSGLT2 de 6 spécialistes prescripteurs de
2015 à 2021 au Canada. Nous avons évalué ces tendances sur le plan de la classe, de
l’agent et de la dose au moyen de la régression Joinpoint.
Résultats
De 2015 à 2021, le nombre total estimé d’ordonnances exécutées par les pharmacies
au détail d’iSGLT2 de tous les prescripteurs avait augmenté. Par rapport aux autres
prescripteurs, > 60 % des ordonnances d’iSGLT-2 étaient rédigées par des omnipraticiens
ou des médecins de famille. Le pourcentage d’ordonnances des endocrinologues avait
diminué (variation moyenne annuelle en pourcentage : moyenne, −10,8 ; intervalle de
confiance [IC] à 95 %, de −12,2 % à −9,4 %), alors qu’une augmentation spectaculaire
des ordonnances des cardiologues avait été observée (moyenne, 44,1 %, IC à 95 %, de
32,9 à 56,2). Le pourcentage des néphrologues avait aussi augmenté, quoique cette
augmentation était non significative sur le plan statistique (moyenne, 12,4 ; IC à
95 %, de −0,5 à 27,1). Des variations importantes en matière d’agent et de dose des
iSGLT-2 prescrits ont aussi été observées chez les cardiologues et les néphrologues.
Conclusions
Entre 2015 et 2021, il y a eu une augmentation constante du pourcentage des ordonnances
d’iSGLT-2 des cardiologues et des néphrologues, qui reflétait les données probantes
émergentes et les recommandations des lignes directrices.
Keywords
Mots clés
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Article info
Publication history
Published online: November 08, 2022
Accepted:
November 1,
2022
Received in revised form:
October 21,
2022
Received:
September 1,
2022
Identification
Copyright
© 2022 Canadian Diabetes Association.
