Key result
Cancer diagnosis linked to lower SGLT2i prescription rates across guideline-directed indications.
Why the study?
Trends in sodium-glucose cotransporter-2 inhibitor usage among patients with cancer compared to those without cancer are poorly understood.
Are patients with cancer less likely to be prescribed SGLT2 inhibitors compared to patients without cancer among those with guideline indications?
Observational
Are patients with cancer less likely to be prescribed SGLT2 inhibitors compared to patients without cancer among those with guideline indications?
Patients with cancer who have indications for SGLT2 inhibitors (like HFrEF or CKD) are significantly less likely to be prescribed these agents than patients without cancer.
Cancer patients show lower SGLT2i use than non-cancer peers since 2020; leaves open barriers to cardiorenal protection and need for targeted study.
Background: Although cardiovascular and kidney protective properties of sodium-glucose cotransporter-2 inhibitors (SGLT2is) have lead to their increased use in recent years, these trends among patients with cancer are poorly understood. Objective: We evaluated the temporal trends of SGLT2i usage in patients with or without cancer. Methods: Our study population included patients 18 and older having 1 of the following diagnoses: heart failure with reduced ejection fraction (HFrEF), heart failure with preserved ejection fraction, chronic kidney disease (CKD), and cardiovascular disease (CVD) with diabetes (DM). The annual incidence of SGLT2i use was measured within patients with and without cancer within each cohort from 2016 to 2023. Results: Among all study cohorts, the observed yearly incidence of SGLT2i use was considerably lower from 2016 to 2019, never exceeding 2%. Differences in utilization between patient cohorts with and without cancer became visible from 2020 onward, highlighted by differences in 2023 incidence for HFrEF (13.1% noncancer vs. 10.7% cancer), CKD (10.0% noncancer vs. 3.8% cancer), and CVD with DM (7.6% noncancer vs. 5.2% cancer). Conclusion: Observed incidence rates suggest that patients with cancer were less likely to be prescribed SGLT2i compared with patients without cancer. Further research is needed to understand the barriers to the use of cardiorenal protective agents in the cancer patient population.
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Naqvi et al. (2026) conducted an observational in Heart failure, chronic kidney disease, or cardiovascular disease with diabetes. Cancer diagnosis vs. No cancer diagnosis was evaluated on Annual incidence of SGLT2i use. Patients with cancer were less likely to be prescribed SGLT2 inhibitors by 2023 compared to those without cancer (e.g., 10.7% vs 13.1% in HFrEF, 3.8% vs 10.0% in CKD).
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