FACTORS ASSOCIATED WITH SGLT2 INHIBITOR INITIATION IN NEWLY DIAGNOSED TYPE 2 DIABETES PATIENTS: A REAL-WORLD ANALYSIS FROM GERMAN PRIMARY CARE
Author(s)
Karel Kostev, PhD1, Beate Leppert, PhD2, Maximilan Peters, PhD3, Henning Sievert, PhD4, Theresia Sarabhai, M.D., PhD5.
1IQVIA, Franfurt am Main, Germany, 2IQVIA, Leipzig, Germany, 3IQVIA, Munich, Germany, 4IQVIA, Hamburg, Germany, 5Medical Faculty and University Hospital Essen, University Duisburg-Essen, Essen, Germany.
1IQVIA, Franfurt am Main, Germany, 2IQVIA, Leipzig, Germany, 3IQVIA, Munich, Germany, 4IQVIA, Hamburg, Germany, 5Medical Faculty and University Hospital Essen, University Duisburg-Essen, Essen, Germany.
OBJECTIVES: SGLT2 inhibitors have demonstratedcardiovascular and renal benefits, yet their uptake in type 2 diabetes (T2D)remains incomplete in routine clinical practice. Understanding which patientcharacteristics are associated with prescribing decisions is essential toidentify potential gaps in guideline-adherent care.
METHODS: In this retrospectivecohort study, patients with an initial T2D diagnosis between 2017-2024 and arecorded baseline HbA1c were identified from 995 primary care practices in theIQVIA Disease Analyzer database. Their prescription histories were combinedwith records from the IQVIA Longitudinal Prescription (LRx) database using avalidated co-therapy-based approach. The primary outcome was first SGLT2inhibitor prescription within five years of diagnosis. Multivariable Coxregression assessed associations with age, sex, HbA1c, and comorbidities.
RESULTS: The study included 44,192 T2D patients (meanage: 65.3 ± 12.6 years; 51.4% female). Within five years, 17.8% (95% CI:17.4-18.3%) received an SGLT2 inhibitor, with a median time to firstprescription of 586 days (IQR: 143-1,103). Without HbA1c adjustment, youngerage, male sex, heart failure (HR: 1.67; 95% CI: 1.54-1.80), ischemic heartdisease (HR: 1.37; 1.29-1.46), and obesity (HR: 1.26; 1.19-1.34) wereassociated with higher prescribing. After HbA1c adjustment, the age associationdisappeared, while elevated HbA1c (7.5-8.4%: HR: 2.30; ≥8.5%: HR: 4.30), malesex, heart failure, ischemic heart disease, obesity, and additionally chronickidney disease were significantly associated with SGLT2 prescribing.
CONCLUSIONS: The study included 44,192 T2D patients (meanage: 65.3 ± 12.6 years; 51.4% female). Within five years, 17.8% (95% CI:17.4-18.3%) received an SGLT2 inhibitor, with a median time to firstprescription of 586 days (IQR: 143-1,103). Without HbA1c adjustment, youngerage, male sex, heart failure (HR: 1.67; 95% CI: 1.54-1.80), ischemic heartdisease (HR: 1.37; 1.29-1.46), and obesity (HR: 1.26; 1.19-1.34) wereassociated with higher prescribing. After HbA1c adjustment, the age associationdisappeared, while elevated HbA1c (7.5-8.4%: HR: 2.30; ≥8.5%: HR: 4.30), malesex, heart failure, ischemic heart disease, obesity, and additionally chronickidney disease were significantly associated with SGLT2 prescribing.Keywords: SGLT2 inhibitors;type 2 diabetes; real-world evidence; primary care; Germany
METHODS: In this retrospectivecohort study, patients with an initial T2D diagnosis between 2017-2024 and arecorded baseline HbA1c were identified from 995 primary care practices in theIQVIA Disease Analyzer database. Their prescription histories were combinedwith records from the IQVIA Longitudinal Prescription (LRx) database using avalidated co-therapy-based approach. The primary outcome was first SGLT2inhibitor prescription within five years of diagnosis. Multivariable Coxregression assessed associations with age, sex, HbA1c, and comorbidities.
RESULTS: The study included 44,192 T2D patients (meanage: 65.3 ± 12.6 years; 51.4% female). Within five years, 17.8% (95% CI:17.4-18.3%) received an SGLT2 inhibitor, with a median time to firstprescription of 586 days (IQR: 143-1,103). Without HbA1c adjustment, youngerage, male sex, heart failure (HR: 1.67; 95% CI: 1.54-1.80), ischemic heartdisease (HR: 1.37; 1.29-1.46), and obesity (HR: 1.26; 1.19-1.34) wereassociated with higher prescribing. After HbA1c adjustment, the age associationdisappeared, while elevated HbA1c (7.5-8.4%: HR: 2.30; ≥8.5%: HR: 4.30), malesex, heart failure, ischemic heart disease, obesity, and additionally chronickidney disease were significantly associated with SGLT2 prescribing.
CONCLUSIONS: The study included 44,192 T2D patients (meanage: 65.3 ± 12.6 years; 51.4% female). Within five years, 17.8% (95% CI:17.4-18.3%) received an SGLT2 inhibitor, with a median time to firstprescription of 586 days (IQR: 143-1,103). Without HbA1c adjustment, youngerage, male sex, heart failure (HR: 1.67; 95% CI: 1.54-1.80), ischemic heartdisease (HR: 1.37; 1.29-1.46), and obesity (HR: 1.26; 1.19-1.34) wereassociated with higher prescribing. After HbA1c adjustment, the age associationdisappeared, while elevated HbA1c (7.5-8.4%: HR: 2.30; ≥8.5%: HR: 4.30), malesex, heart failure, ischemic heart disease, obesity, and additionally chronickidney disease were significantly associated with SGLT2 prescribing.Keywords: SGLT2 inhibitors;type 2 diabetes; real-world evidence; primary care; Germany
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH6
Topic
Epidemiology & Public Health, Patient-Centered Research, Real World Data & Information Systems
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)