Disparities in sodium-glucose cotransporter-2 inhibitor usage between patients with and without cancer: A retrospective study

Background: Although cardiovascular and kidney protective properties of sodium-glucose cotransporter-2 inhibitors (SGLT2is) have lead to their increased use in recent years, these trends among patients with cancer are poorly understood. Objective: We evaluated the temporal trends of SGLT2i usage in patients with or without cancer. Methods: Our study population included patients 18 and older having 1 of the following diagnoses: heart failure with reduced ejection fraction (HFrEF), heart failure with preserved ejection fraction, chronic kidney disease (CKD), and cardiovascular disease (CVD) with diabetes (DM). The annual incidence of SGLT2i use was measured within patients with and without cancer within each cohort from 2016 to 2023. Results: Among all study cohorts, the observed yearly incidence of SGLT2i use was considerably lower from 2016 to 2019, never exceeding 2%. Differences in utilization between patient cohorts with and without cancer became visible from 2020 onward, highlighted by differences in 2023 incidence for HFrEF (13.1% noncancer vs. 10.7% cancer), CKD (10.0% noncancer vs. 3.8% cancer), and CVD with DM (7.6% noncancer vs. 5.2% cancer). Conclusion: Observed incidence rates suggest that patients with cancer were less likely to be prescribed SGLT2i compared with patients without cancer. Further research is needed to understand the barriers to the use of cardiorenal protective agents in the cancer patient population.