Please use this identifier to cite or link to this item:
10.1186/s12933-020-01154-w
Title: | Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes |
Authors: | Schernthaner, Guntram Shehadeh, Naim Ametov, Alexander S. Bazarova, Anna V. Ebrahimi, Fahim Fasching, Peter Janež, Andrej Kempler, Péter Konrāde, Ilze Lalić, Nebojša M. Mankovsky, Boris Martinka, Emil Rahelić, Dario Serafinceanu, Cristian Škrha, Jan Tankova, Tsvetalina Visockienė, Žydrūnė Rīga Stradiņš University |
Keywords: | Cardiorenal protection;Clinical inertia;Glucose lowering drugs;Type 2 diabetes;3.1 Basic medicine;1.1. Scientific article indexed in Web of Science and/or Scopus database;Internal Medicine;Endocrinology, Diabetes and Metabolism;Cardiology and Cardiovascular Medicine;SDG 3 - Good Health and Well-being |
Issue Date: | 1-Dec-2020 |
Citation: | Schernthaner , G , Shehadeh , N , Ametov , A S , Bazarova , A V , Ebrahimi , F , Fasching , P , Janež , A , Kempler , P , Konrāde , I , Lalić , N M , Mankovsky , B , Martinka , E , Rahelić , D , Serafinceanu , C , Škrha , J , Tankova , T & Visockienė , Ž 2020 , ' Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes ' , Cardiovascular Diabetology , vol. 19 , no. 1 , 185 . https://doi.org/10.1186/s12933-020-01154-w |
Abstract: | The disclosure of proven cardiorenal benefits with certain antidiabetic agents was supposed to herald a new era in the management of type 2 diabetes (T2D), especially for the many patients with T2D who are at high risk for cardiovascular and renal events. However, as the evidence in favour of various sodium–glucose transporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) accumulates, prescriptions of these agents continue to stagnate, even among eligible, at-risk patients. By contrast, dipeptidyl peptidase-4 inhibitors (DPP-4i) DPP-4i remain more widely used than SGLT2i and GLP-1 RA in these patients, despite a similar cost to SGLT2i and a large body of evidence showing no clear benefit on cardiorenal outcomes. We are a group of diabetologists united by a shared concern that clinical inertia is preventing these patients from receiving life-saving treatments, as well as placing them at greater risk of hospitalisation for heart failure and progression of renal disease. We propose a manifesto for change, in order to increase uptake of SGLT2i and GLP-1 RA in appropriate patients as a matter of urgency, especially those who could be readily switched from an agent without proven cardiorenal benefit. Central to our manifesto is a shift from linear treatment algorithms based on HbA1c target setting to parallel, independent considerations of atherosclerotic cardiovascular disease, heart failure and renal risks, in accordance with newly updated guidelines. Finally, we call upon all colleagues to play their part in implementing our manifesto at a local level, ensuring that patients do not pay a heavy price for continued clinical inertia in T2D. |
Description: | Funding Information: Organisation of the meeting and editorial support was provided by Boehringer Ingelheim with the support of the medical communications agency Fortis Pharma Communications. Acknowledgements Funding Information: Editorial support was provided by Fortis Pharma Communications, with financial support by Boehringer Ingelheim (BI). The opinions expressed are entirely the authors’ own and the only involvement of BI was to have sight of the manuscript for accuracy. Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved. |
DOI: | 10.1186/s12933-020-01154-w |
ISSN: | 1475-2840 |
Appears in Collections: | Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure |
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