1841-P: Disparities in Sodium–Glucose Cotransporter Inhibitors (SGLTi) Use: A Systematic Literature Review

Introduction and Objective: Despite the established efficacy of SGLTi in type 2 diabetes (T2D), heart failure (HF) and chronic kidney disease (CKD), evidence indicates inconsistent access to these treatments. This systematic literature review (SLR) examined published use of SGLTi in patients with T2D, HF, or CKD in the US that included data by patient sociodemographics. Methods: We performed an SLR of observational studies published from 2019- June 10, 2025 of adult patients in the US with T2D, HF, or CKD receiving SGLTi to identify sociodemographic factors associated with disparities in SGLTi use. Results: Of 1696 records screened by review of titles and abstracts, 123 full-text reports were assessed, and 23 publications of model-based assessments were included. Statistically significant disparities in SGLTi use, regardless of the outcomes measured, were observed in the following sociodemographic factors: age, sex, race, education, income, and insurance type (Table). However, the results were mixed, especially in studies with diverse subgroups and different co-payment or other characteristics, although trends were identified. Conclusion: Although results were inconsistent, the trends observed suggest older age, female sex, Black race, and Medicare insurance are associated with disparities in SGLTi use in the US. Future research should further evaluate these disparities, their impact on patient outcomes, and potential solutions. Disclosure M. Budoff: Speaker's Bureau; Current; Amgen Inc. Research Support; Current; Lilly. Speaker's Bureau; Current; Novo Nordisk A/S, Lilly. K.C. Norris: Consultant; Current; Atlantis Health Care Inc. A. Peters: Advisory Panel; Current; Vertex Pharmaceuticals Incorporated, Medscape. Research Support; Ended; Abbott Diabetes. Research Support; Current; Insulet Corporation, Zucara Therapeutics. Stock/Shareholder; Current; Omada Health, Inc. Funding Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI) and Lilly USA, LLC.