SGLT-2 inhibitors and GLP-1 receptor agonists in primary care pharmacotherapy of type 2 diabetes in people living with HIV versus HIV-negative controls: Findings from a multicenter study in Germany

AIMS: Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve glycemic control and reduce cardiovascular (CV) mortality. However, evidence regarding their real-world utilization in people living with HIV (PLWH) receiving primary care remains limited. METHODS: The present study evaluates the real-world diabetes management, prescription patterns and outcomes in PLWH with type 2 diabetes (T2D) compared to HIV-negative controls in primary care, using retrospective and prospective data from multiple outpatient healthcare facilities from urban outpatient clinics in Germany. RESULTS: No significant difference was found for treatment with either SGLT-2i or GLP-1 RA (PLWH [30.0 %] vs. controls [28.3 %], p = 0.86) or the combined therapy (p = 0.34). Among participants with established CV disease, only a third received an SGLT-2i and/or a GLP-1 RA (p = 0.63). Regarding quality of life, PLWH had more difficulties with self-care (p = 0.038) and there was a trend towards a greater burden of anxiety and depression (p = 0.051). CONCLUSIONS: PLWH and T2D in primary care received similar evidence-based therapies as controls, however, prescription rates in participants with CV disease were relatively low. Future studies with a larger sample size and longitudinal follow-up are needed to confirm the present findings.