1833-P: National Patterns of SGLT2i and GLP-1RA Use in U.S. Cancer Survivors with Diabetes

Introduction and Objective: Among adults with diabetes, cancer survivors (DM+c) have higher cardiovascular disease (CVD) risk than those without cancer (DM-c). Although sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1RA) reduce the risk of CVD, little is known regarding the use of these drugs among adults with diabetes and cancer. Methods: We analyzed weighted 2015-2020 data from US National Health and Nutrition Examination Survey (NHANES) to compare GLP1RA and SGLT2i use in adults with diabetes with cancer vs. without cancer. We examined subgroups with comorbidity-based drug indications (ischemic heart disease, stroke, myocardial infarction, congestive heart failure [CHF], and/or chronic kidney disease with [eGFR 20-60mL/min/1.73m2]). We used logistic regression to examine if cancer history predicted SGLT2i and/or GLP1RA use, adjusting for sociodemographic and clinical variables. Results: Our analytic sample included 16.0 million weighted adults (DM+c: 2 million (non-weighted: 146), DM-c: 14 million (non-weighted: 1123)). Adults with DM+c were older than DM-c (68 year-old [SD 11] vs. 59 year-old [SD 14]) and more likely to have comorbidity-based indications (49.9% vs. 33.8%). From 2015 to 2020, 0.6% and 2.6% of DM+c patients used SGLT2i or GLP1RA (p<0.01), vs. 5.4% and 3.3% in DM-c (p<0.01), respectively. From 2015-2016 to 2017-2020, SGLT2i use increased 2.8% to 9.7% in DM-c but declined 2.2% to 0.3% in DM+c; GLP-1RA use decreased 5.4% to 3.4% in DM-c and 5.3% to 3.5% in DM+c. Cancer history did not significantly predict GLP1RA and/or SGLT2i use. The only significant predictor was DM duration (OR=1.05 per year, 95% CI:1.01-1.10). Conclusion: Cardioprotective DM drugs are substantially underused, especially in DM+c. Given higher CVD risk among adults with diabetes and cancer, identifying barriers to use is critical. Future research should explore trends in later years and barriers to use. Disclosure E. Billman: None. J.J. Lin: None. B.S. Ferket: None. C. Kong: None. J. Wisnivesky: Consultant; Current; Sanofi, PPD, Banook, AMA. Research Support; Current; Regeneron, Sanofi, Axella, BI. T. Moin: None. A. Leiter: None.