Abstract 14504: Gender and Racial Disparities in Patients Using Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors and Glucagon-Like Peptide-1 (GLP-1) Analogues in a Real-World Scenario

Abstract

Introduction: Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors and Glucagon-like Peptide-1 (GLP-1) analogues are relatively new classes of prescription drugs showing promising benefits for cardiovascular outcomes. There is a paucity of data regarding the cardiovascular risk profile of patients receiving these medications outside of clinical trials. We aim to describe the same in the Medstar Health outpatient population and to explore whether there are any racial/gender disparities. Methods: Records were obtained for 12,305 patients who had been reviewed as outpatients in the Medstar Health System and prescribed either an SGLT2-I or a GLP1-A between 2018 and 2021 inclusive. 2379 patients had sufficient data to allow calculation of their athero-sclerotic cardiovascular disease (ASCVD) risk. Variables collected included demographic information, selective vitals, and lab values. Patients’ ASCVD risk was calculated where appropriate using 2013 ACC/AHA guidelines. Results: Of 2379 patients, 1695 (71.2%) were prescribed a GLP1-A and 684 (28.8%) an SGLT2-i. Groups did not differ in terms of smoking status, use of anti-hypertensive medications, history of ACS or stroke, systolic blood pressure, or cholesterol levels. The GLP1-A group had more female patients (60.4% vs. 45.8% in the SGLT2-i group, p < 0.001), more African American patients (52.0% vs. 40.0%, p < 0.001), and fewer patients with diabetes mellitus (26.3% vs. 27.9%, p < 0.001). The GLP1-A group was also significantly younger, had a higher average BMI, and higher average HDL and lower average HbA1c (7.68 vs 8.06, p < 0.001). 10-year ASCVD risk was significantly higher in patients prescribed an SGLT-2 inhibitor (18.10 vs 15.66, p < 0.001). Conclusions: Among demographic indicators, there were proportionally more women and African-Americans in the GLP1-A group than in the SGLT2-i group, which may indicate disparity in utilization of these drugs for certain populations. There were more diabetics in the SGLT2-i group, likely reflecting the use of GLP1-As for obesity in non-diabetics. The 10-year ASCVD risk was lower in the GLP1-A group compared to the SGLT2-i group. Further research will explore the clinical outcomes of these groups.