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Prescribing Trends of the Sodium Glucose Cotransporter-2 (SGLT-2) Inhibitors Among Different Physician Specialties in Canada (2015-2021).

Published:November 08, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.11.002
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      Abstract

      Background

      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 six 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, 95%CI= -10.8, -12.2 to -9.4), while a dramatic increase was observed for cardiologists (44.1, 32.9 to 56.2). The percentage from nephrologists also increased, albeit not statistically significant (12.4, -0.5 to 27.1). Significant changes in the agent and dose of SGLT-2 inhibitor prescribed were also observed among cardiologists and nephrologists.

      Interpretation

      Between 2015 and 2021, there was a steady increase in the proportion of SGLT-2 inhibitors prescriptions from cardiologists and nephrologists, reflecting emerging evidence and guideline recommendations.
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