TY - JOUR
T1 - Incorporating SGLT2i and GLP-1RA for Cardiovascular and Kidney Disease Risk Reduction
T2 - Call for Action to the Cardiology Community
AU - Nelson, Adam J.
AU - Pagidipati, Neha J.
AU - Aroda, Vanita R.
AU - Cavender, Matthew A.
AU - Green, Jennifer B.
AU - Lopes, Renato D.
AU - Al-Khalidi, Hussein
AU - Gaynor, Tanya
AU - Kaltenbach, Lisa A.
AU - Kirk, Julienne K.
AU - Lingvay, Ildiko
AU - Magwire, Melissa L.
AU - O'Brien, Emily C.
AU - Pak, Jonathan
AU - Pop-Busui, Rodica
AU - Richardson, Caroline R.
AU - Reed, Monica
AU - Senyucel, Cagri
AU - Webb, Laura
AU - McGuire, Darren K.
AU - Granger, Christopher B.
N1 - Funding Information:
Dr Nelson reports grants from Diabetes Australia and the Royal Australasian College of Physicians. Dr Pagidipati reports grants from Amgen, Regeneron Pharmaceuticals, Sanofi-Aventis, and Verily Life Sciences. Dr Aroda reports consulting fees from Duke University, Liberum, Novo Nordisk, and Sanofi; research grant support paid to her institution from Applied Therapeutics, Fractyl/ Premier, Novo Nordisk, and Sanofi; and her spouse was/is an employee of Merck and Janssen. Dr Cavender reports consulting fees from AstraZeneca, Boehringer Ingelheim, Edwards Lifesciences, Merck, and Sanofi-Aventis; and has received research funding (nonsalary) from Amgen, AstraZeneca, Bristol-Myers Squibb, Chiesi, GlaxoSmithKline, Novartis, and Takeda and research funding (salary) from Novo-Nordisk. Dr Green reports grants from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Sanofi; and personal fees from AstraZeneca, Merck, Boehringer‐Ingelheim, Sanofi/Regeneron, and Novo Nordisk. Dr Lopes reports grants and personal fees from Bristol-Myers Squibb and Pfizer, personal fees from Boehringer Ingelheim and Bayer AG, and grants from Amgen Inc, GlaxoSmithKline, Medtronic PLC, and Sanofi Aventis. T. Gaynor is an employee of Boehringer Ingelheim. Dr Lingvay reports grant support from Merck, Mylan, Novo Nordisk, Pfizer, and Sanofi; personal fees from AstraZen-eca, Boehringer Ingelheim, Eli Lilly, Intarcia, Janssen, Mannkind, Novo Nordisk, Sanofi, Target Pharma, and Valeritas; and nonfinancial support from AstraZen-eca, Boehringer Ingelheim, Eli Lilly, Janssen, Novo Nordisk, Pfizer, and Sanofi. M.L. Magwire reports consulting fees from Boehringer Ingelheim and Novo Nordisk. Dr O’Brien reports grants from Novartis, BMS, and GlaxoSmithKline. Dr Pak is an employee of Boehringer Ingelheim. Dr Pop-Busui reports research support (to the University of Michigan) from AstraZeneca and grant support from the National Institutes of Health (grants NIDDK-1-R01-DK-107956-01 and UC4 DK101108). Dr Senyucel is an employee of Lilly Pharmaceuticals. Dr McGuire reports personal fees from Boehringer Ingelheim, Janssen Research and Development LLC, Sanofi US, Merck & Co, Merck Sharp and Dohme Corp, Eli Lilly USA, Novo Nordisk, GlaxoSmithKline, AstraZeneca, Lexicon Pharmaceuticals, Eisai, Pfizer, Metavant, Applied Therapeutics, Afimmune, and Espe-rion. Dr Granger reports research grants and consulting/speaker fees from Boehringer Ingelheim, Bristol-Myers Squibb, Janssen Pharmaceutical Products, LP, and Pfizer; research grants from AKROS, Apple, AstraZeneca, Daichi-San-kyo, US Food & Drug Administration, GlaxoSmithKline, Medtronic Foundation, and Novartis Pharmaceutical Company; and consulting/speaker fees from Ab-bVie, Bayer Corp US, Boston Scientific Corp, CeleCor Therapeutics, Correvio, Espero BioPharma, Medscape, Medtronic Inc, Merck, National Institutes of Health, Novo Nordisk, Rhoshan Pharmaceuticals, and Roche Diagnostics. The other authors report no conflicts.
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/7/6
Y1 - 2021/7/6
N2 - Multiple sodium glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to impart significant cardiovascular and kidney benefits, but are underused in clinical practice. Both SGLT-2i and GLP-1RA were first studied as glucose-lowering drugs, which may have impeded uptake by cardiologists in the wake of proven cardiovascular efficacy. Their significant effect on cardiovascular and kidney outcomes, which are largely independent of glucose-lowering effects, must drive a broader use of these drugs. Cardiologists are 3 times more likely than endocrinologists to see patients with both type 2 diabetes and cardiovascular disease, thus they are ideally positioned to share responsibility for SGLT-2i and GLP-1RA treatment with primary care providers. In order to increase adoption, SGLT-2i and GLP-1RA must be reframed as primarily cardiovascular and kidney disease risk-reducing agents with a side effect of glucose-lowering. Coordinated and multifaceted interventions engaging clinicians, patients, payers, professional societies, and health systems must be implemented to incentivize the adoption of these medications as part of routine cardiovascular and kidney care. Greater use of SGLT-2i and GLP-1RA will improve outcomes for patients with type 2 diabetes at high risk for cardiovascular and kidney disease.
AB - Multiple sodium glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to impart significant cardiovascular and kidney benefits, but are underused in clinical practice. Both SGLT-2i and GLP-1RA were first studied as glucose-lowering drugs, which may have impeded uptake by cardiologists in the wake of proven cardiovascular efficacy. Their significant effect on cardiovascular and kidney outcomes, which are largely independent of glucose-lowering effects, must drive a broader use of these drugs. Cardiologists are 3 times more likely than endocrinologists to see patients with both type 2 diabetes and cardiovascular disease, thus they are ideally positioned to share responsibility for SGLT-2i and GLP-1RA treatment with primary care providers. In order to increase adoption, SGLT-2i and GLP-1RA must be reframed as primarily cardiovascular and kidney disease risk-reducing agents with a side effect of glucose-lowering. Coordinated and multifaceted interventions engaging clinicians, patients, payers, professional societies, and health systems must be implemented to incentivize the adoption of these medications as part of routine cardiovascular and kidney care. Greater use of SGLT-2i and GLP-1RA will improve outcomes for patients with type 2 diabetes at high risk for cardiovascular and kidney disease.
KW - cardiovascular diseases
KW - diabetes mellitus, type 2
KW - glucagon-like peptide-1 receptor
KW - heart failure
KW - kidney diseases
KW - prevention & control
KW - sodium-glucose transporter 2 inhibitors
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UR - http://www.scopus.com/inward/citedby.url?scp=85109325342&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.121.053766
DO - 10.1161/CIRCULATIONAHA.121.053766
M3 - Article
C2 - 34228476
AN - SCOPUS:85109325342
SN - 0009-7322
VL - 144
SP - 74
EP - 84
JO - Circulation
JF - Circulation
IS - 1
ER -