AUTHOR=Li Cao , Guo Shanshan , Huo Jiping , Gao Yiming , Yan Yilong , Zhao Zhigang 

TITLE=Real-world national trends and socio-economic factors preference of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists in China

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.987081

DOI=10.3389/fendo.2022.987081

ISSN=1664-2392

ABSTRACT=Backgrounds: Robust evidences has demonstrated beneficial effect of Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) in T2D patients with cardiovascular diseases and chronic kidney disease. Multiple studies analyzed patterns and predictors of SGLT2i and GLP-1RA in US, Europe and worldwide, however, there is no study about the utilization of these two classes of drugs in real-world 
Method: A total of 181743 prescriptions of SGLT2i and 59720 GLP-1RA were retrospectively pooled from Hospital Prescription Analysis Cooperation Project from 2018 to 2021. Social-economic characteristics of patients and prescriber including age, gender, residency, hospital level, insurance type, department visited, payment amount was collected and analyzed to study trends and risk factors associated with preference among two antidiabetics.
Results: Annual number of prescriptions of SGLT2i significantly increased to approximately 140 folds, while GLP-1RA increased to about 6.5 folds. After adjustment for socio-economic information, several patients or physician characteristics were positively associated with preference of GLP-1RA, including female gender (OR 1.581, 95% CI 1.528-1.635), residents in first-tier city (OR 1.194, 95% CI 1.148-1.142), visiting primary or secondary hospital level (OR 2.387, 95% CI 2.268-2.512); while other factors were associated with preference of SGLT2i, including relative younger adults (OR 0.713, 95% CI 0.688-0.739), uncovered by insurance (OR 0.310, 95% CI 0.293-0.329), visiting endocrinology compared with other departments In addition, the share of SGLT2i and GLP-1RA was low but in an increasing tendency.
Conclusions: SGLT2i and GLP-1RA prescription significantly increased from 2018 to 2021. The socio-economic risk factors in choosing SGLT2i or GLP-1RA highlights an effort required to reduce disparities and improve health outcomes.