SGLT-2 Inhibitors Use in Hospitalized Patients in France: A Cross-Sectional Study

Sodium glucose co-transporter type 2 inhibitors (SGLT2i) were initially developed as glucose-lowering drugs for diabetic patients. A few years after their market authorization in Europe, their indications were expanded to include first, heart failure (HF) and, subsequently, chronic kidney disease (CKD). These expansions led to a rapid increase in the use of this drug class and a diversification of the treated patient profile in the "real-life."

Describe in-hospital SGLT2i user profiles and evaluate compliance with guidelines.

A descriptive cross-sectional study was conducted using the Bordeaux University Hospital's clinical data warehouse. It included a random sample of 250 hospital stays of different patients with at least one administration of SGLT2i between February 1, 2022, and January 31, 2023. SGLT2i user profiles were described in terms of indications. Drug co-prescriptions were also described to evaluate compliance with guidelines.

The majority of patients were aged 60-79 (59.6%), and were men (75.2%). HF was found in 87.2% of the patients treated with SGLT2i, followed by T2DM (45.2%) and CKD (21.2%). The most frequent indication profiles were HF without type II diabetes or CKD (42.0%) followed by HF and diabetes without CKD (26.0%). No patient had CKD as the sole indication. Prescriptions were considered compliant with guidelines for 76.4% of patients. Suboptimal prescriptions were mainly due to absence of another recommended drug without justification.

SGLT2i are now primarily used to treat HF. Their therapeutic potential in CKD appears to be still underestimated. Overall, compliance with guidelines appears satisfactory.