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SGLT2 inhibitors use in France: A nationwide drug utilization study
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International audience. Introduction: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are commercialized in France since April 2020 with an initial indication in type 2 diabetes. In this context, we aimed to measure the prevalence and incidence of SGLT2i use compared to other antidiabetic drugs and to describe the characteristics of SGLT2i initiators.Material and methods: We performed a repeated quarterly cross-sectional study using the French health insurance database (SNDS) between January 1st, 2019 and December 31st, 2021. Patients were selected if they had at least one delivery of an antidiabetic drug within each quarter. Population estimates from the National Institute of Statistics and Economic Studies (INSEE) were chosen as denominator. Characteristics of SGLT2i initiators were described from a cohort of incident users, in terms of demographic characteristics, comorbidities and antidiabetic drug co-prescriptions.Results: The prevalence of SGLT2i use increased progressively and reach 0.15% at the end of 2021. For the other antidiabetic drugs, prevalence of use increased for metformin and GLP1 agonists but decreased slightly for sulfonylureas. SGLT2i incidence increased quickly (0.08% at the end of 2021) with an acceleration of use at the time of indication extensions to heart failure (March 2021) and chronic kidney disease (October 2021). Among the other antidiabetic drugs, we observed an increased incidence of the use of GLP1 agonists. Among the cohort of 125 772 SGLT2i incident users (mean age 65.1 years ± 12.1; 60.1% of men), 87% had previously at least one diagnosis code for diabetes or another antidiabetic delivery. SGLT2i new prescriptions were mainly added to a previous antidiabetic treatment rather than switched. Interestingly, 12,6% of SGLT2i initiators had only one delivery of this drug.Discussion/Conclusion: The rapid increase in the use of SGLT2i in diabetes or other indications justifies close monitoring of the use of these drugs and the reasons for their discontinuation.
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