OBJECTIVE There is a paucity of data evaluating recent changes in clinical and prescriber characteristics of patients initiating sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA). RESEARCH DESIGN AND METHODS U.S.-based administrative-claims data (July 2013 to June 2018) were used to identify initiators of SGLT2i and GLP-1RA. RESULTS Over 5 years, empagliflozin initiation (as a proportion of SGLT2i) increased by 57.1% (P < 0.001 for trend), while canagliflozin initiation declined by 75.1% (P < 0.001). Empagliflozin was the only agent within SGLT2i with an increase in the proportion of patients with myocardial infarction, stroke, or heart failure (collectively called CVD-HF) (P < 0.001). Liraglutide initiation (as a proportion of total GLP-1RA) declined by 32.1% (P < 0.001), and dulaglutide initiation increased by 34.1% (P < 0.001); the proportion of patients with CVD-HF increased the most in liraglutide initiators (5.1% increase; P < 0.001). Most prescribers were internists or endocrinologists; cardiologist prescribing remained low (<1%). CONCLUSIONS For SGLT2i, shifts in preference for empagliflozin followed changes in drug labels and guidelines, while in GLP-1RA, other factors such as price or ease of administration may have led to a preference for dulaglutide over liraglutide.

中文翻译：

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SGLT2 抑制剂和 GLP-1 受体激动剂的临床特征和处方偏好趋势，2013-2018 年。

目的 评估开始使用钠-葡萄糖协同转运蛋白 2 抑制剂 (SGLT2i) 和胰高血糖素样肽 1 受体激动剂 (GLP-1RA) 的患者的临床和处方者特征的近期变化的数据很少。研究设计和方法 基于美国的行政索赔数据（2013 年 7 月至 2018 年 6 月）用于识别 SGLT2i 和 GLP-1RA 的发起者。结果 5 年多来，恩格列净起始（作为 SGLT2i 的比例）增加了 57.1%（趋势 P < 0.001），而卡格列净起始下降了 75.1%（P < 0.001）。Empagliflozin 是 SGLT2i 中唯一增加心肌梗死、中风或心力衰竭（统称为 CVD-HF）患者比例的药物（P < 0.001）。利拉鲁肽起始（占总 GLP-1RA 的比例）下降了 32.1%（P < 0.001），度拉糖肽起始剂量增加了 34.1%（P < 0.001）；在利拉鲁肽起始剂中，CVD-HF 患者的比例增加最多（增加 5.1%；P < 0.001）。大多数开药者是内科医生或内分泌科医生；心脏病专家的处方仍然很低（<1%）。结论 对于 SGLT2i，恩格列净偏好的变化跟随药物标签和指南的变化，而在 GLP-1RA 中，其他因素（例如价格或给药方便性）可能导致对度拉糖肽的偏好超过利拉鲁肽。