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Utilization Trends of SGLT2 Inhibitors in Croatian Clinical Practice: Observational Analysis
Andrej Belančić1, Marta Kučan Štiglić1, Ana Jelaković2,3
1Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
Sodium-glucose co-transporter 2 (SGLT2) inhibitor use in Croatia grew significantly from 2014-2024, but monotherapy remains underutilized. Increased use of fixed-dose combinations suggests a move towards better adherence in diabetes management.
Area of Science:
- Pharmacology
- Endocrinology
- Public Health
Background:
- Sodium-glucose co-transporter 2 (SGLT2) inhibitors are crucial for type 2 diabetes mellitus (T2DM), heart failure, and chronic kidney disease.
- Understanding national utilization trends is vital for optimizing patient care.
Purpose of the Study:
- To analyze national trends in SGLT2 inhibitor utilization in Croatia from 2014 to 2024.
- To examine prescribing patterns, financial expenditure, and the adoption of fixed-dose combinations.
Main Methods:
- Utilized IQVIA data to quantify drug use in defined daily doses per 1000 inhabitants per day (DDD/1000/day).
- Analyzed financial expenditure and prescribing patterns over a decade.
Main Results:
- SGLT2 inhibitor use rose from 0.49 to 11.63 DDD/1000/day between 2014 and 2024.
- Fixed-dose combinations with metformin increased, indicating a preference for adherence-friendly options.
- Dapagliflozin was the most prescribed agent; however, SGLT2 inhibitor monotherapy constituted only 12% of non-insulin antidiabetic prescriptions in 2024.
Conclusions:
- SGLT2 inhibitors are gradually integrated into Croatian clinical practice.
- Targeted educational and policy interventions are needed to address therapeutic inertia and promote evidence-based cardio-renal-metabolic care.
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