Patient and Treatment Characteristics of New Users of SGLT-2i and/or ARNi in HFrEF Patients With and Without T2DM: A Real-World Data Analysis Based on German Claims Data

Speaker(s)

Rauch-Kröhnert U1, Lehrke M2, Stürmlinger A3, Bucksch K4, Kolb N5, Kossack N6
1Deutsches Herzzentrum der Charité, Berlin, Berlin, Germany, 2Kliniken Südostbayern AG, Traunstein, Bavaria, Germany, 3Boehringer Ingelheim Pharma GmbH & Co.KG, Ingelheim am Rhein, RP, Germany, 4WIG2 GmbH (Scientific Institute for Health Economics and Health System Research), Leipzig, Sachsen, Germany, 5ZEG – Berlin Center for Epidemiology and Health Research, Berlin, BE, Germany, 6WIG2 GmbH (Scientific Institute for Health Economics and Health System Research), Leipzig, SN, Germany

OBJECTIVES: This study aimed to assess patient and treatment characteristics of heart failure with reduced ejection fraction (HFrEF) patients initiating sodium glucose linked transporter-2 inhibitors (SGLT-2i) and/or angiotensin receptor-neprilysin inhibitors (ARNi) depending on previous type 2 diabetes mellitus (T2DM) status in Germany.

METHODS: This observational and non-interventional cohort study used anonymized, representative German healthcare claims data of various German sick funds from 01/2019 to 12/2022. Heart failure (HF) patients aged 18 years and older who initiated therapy during January 2021 and June 2022 were included. Patient and treatment characteristics (demographics, comorbidities, and medications) among those starting SGLT-2i, ARNi, or both (SGLT-2i+ARNi) for HFrEF were compared and analyzed separately for patients with and without prior T2DM.

RESULTS: In total, 8,132 new users of SGLT-2i, 3,087 of ARNi, and 1,777 of SGLT-2i+ARNi were included from the database. Comparing initiations with vs. without prior T2DM, there were 6,145 vs. 1,987 users of SGLT-2i, 1,105 vs. 1,982 users of ARNi, and 834 vs. 943 users of SGLT-2i+ARNi. Out of the patients initiating ARNi, more than one-third (36.5%) initiated SGLT-2i at the same time. Overall, 77.5% of the patients were previously treated with Renin-angiotensin-aldosterone system inhibitors (SGLT-2i users: 81.6%; ARNi: 74.4%; SGLT-2i+ARNi: 63.9%), 72.1% with betablockers (SGLT-2i users: 75.0%; ARNi: 72.7%; SGLT-2i+ARNi: 58.0%), 66.9% with diuretics (SGLT-2i users: 68.9%; ARNi: 69.6%; SGLT-2i+ARNi: 53.1%), and 27.8% with Mineralocorticoid receptor antagonists (SGLT-2i users: 26.6%; ARNi: 34.2%; SGLT-2i+ARNi: 22.2%).

CONCLUSIONS: The study showed differences in patient and treatment characteristics of HFrEF patients that align with the different recommendations for the use of SGLT-2i and ARNi. Studies comparing the costs of the two treatments need to take these differences into account. The high proportion of patients starting SGLT-2i and ARNi simultaneously indicates that the efficacy results for SGLT-2i in treating HF have already been adopted in clinical practice before the 2023 guidelines update.

Code

HSD31

Topic

Study Approaches

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Drugs