Abstract: TH-PO1024
Comparison of National and Global Utilization Trends of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) and Glucagon-Like Peptide 1 Receptor Agonists (GLP-1RA) in CKD
Session Information
- CKD Epidemiology, Risk Factors, Prevention - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Nawaz, Iqra, Stony Brook University, Stony Brook, New York, United States
- Bhuiyan, Sakil Amin, Stony Brook University, Stony Brook, New York, United States
- Sheikh, Fatima, Stony Brook University, Stony Brook, New York, United States
- Mallipattu, Sandeep K., Stony Brook University, Stony Brook, New York, United States
Background
Despite the mounting evidence demonstrating the reno and cardiovascular benefits of SGLT2i and GLP-1RA in diabetic and non-diabetic CKD, there appears to be a degree of therapeutic inertia in using these agents in routine clinical practice. The assessment of the utilization rates and practice patterns of these drugs in patients with CKD remains scarce.
Methods
We used TriNetX Analytics, including Stony Brook Healthcare, US-network, AMA (Asia), and EMEA (Middle east, Europe, Africa) collaborative networks. The estimated glomerular filtration rate (eGFR) mL/min/1.73 m2 (CKD-EPI equation) lab values and the KDIGO eGFR classification were used to define the CKD stages. Individuals with age > 18 years with ambulatory visits (CPT 1013626) from 2000 to 2022 were included. Patients with end-stage renal disease (CPT 1019051), acute kidney injury (ICD-10-CM N17), and kidney transplant recipients (CPT 50380) were excluded.
Results
SGLT2i and GLP-1RA use were highest among non-Hispanic white males (55% vs 55%) with Type 2 DM (86% vs 79%) and Hypertension (87% and 82%). The use rates of ACEi/ARB were noticeably low among all cohorts; 34% (280,0219) in the US, 28% (77,011), and 11% (38,599) in the AMA and EMEA groups. In the AMA group, the SGLT2i use rate was 4% (11,786), and the lowest prescription rate was noticed in the EMEA group at 0.40% (1681). The prevalence of GLP-1RA use was relatively higher in Stony Brook and US cohorts, 2.60% (4370) and 3% (230,925), as compared to AMA and EMEA groups at 0.50% (1763) and 0.12% (431), respectively.
Conclusion
Despite the high national and global burden of CKD, the prescription rates of ACEi/ARBs are alarmingly low. In contrast, a relatively high prevalence of potential nephrotoxins (i.e., NSAIDs and PPIs) use has been noticed. Overall national and global SGLT2i and GLP-1 RA utilization rates have increased over the last few years. However, the use rates of these agents are still significantly suboptimal among CKD patients.