SGLT2 inhibitors and cardioprotection. Literature review and real-world data from Poland

Abstract

Background Sodium-glucose cotransporter-2 (SGLT2) has been demonstrated to reduce cardiovascular events in randomized controlled settings. This group of drugs has been reimbursed for a selected group of patients in Poland since 2019. A decision to extend the reimbursement would be considered after analyzing the real-world data of the SGLT2 in Polish conditions. The aim of this study was the assessment of current evidence, both from the literature and real data from the health care system. Methods The targeted literature review was made based on high-quality articles on the topic of interest. Randomized clinical trials and publications based on real-world data were collected. Collaterally, data from the Polish third-party payer, National Health Fund (NHF), for 2020 was gathered. Results Ten publications were included in the final analysis. They showed that the use of cardioprotectors in the treatment reduces cardiovascular events and lowers the rate of hospitalization for heart failure, regardless of pre-existing CVD or diabetes. Having regard the NHF data from Lesser Poland, in SGLT2 group, there were 196 out of 5,332 patients hospitalized due to cardiovascular incidents (3.68%). This percentage is lower than in the whole insulin group (5.06%) and close to the subgroup who started therapy in a similar period as SGLT2 group (5.07%). Conclusions SGLT2 significantly affects the treatment of cardiovascular events across the countries reported in the literature. Our study, the first real-world evidence from Poland, proves the cardioprotective effect of these groups of drugs as well. The main limitation is data restricted to one region, thus future studies with whole country coverage are needed.