SGLT-2 inhibitors and GLP-1 receptor agonists in primary care pharmacotherapy of type 2 diabetes in people living with HIV versus HIV-negative controls: Findings from a multicenter study in Germany.

Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve glycemic control and reduce cardiovascular (CV) mortality. However, evidence regarding their real-world utilization in people living with HIV (PLWH) receiving primary care remains limited. The present study evaluates the real-world diabetes management, prescription patterns and outcomes in PLWH with type 2 diabetes (T2D) compared to HIV-negative controls in primary care, using retrospective and prospective data from multiple outpatient healthcare facilities from urban outpatient clinics in Germany. No significant difference was found for treatment with either SGLT-2i or GLP-1 RA (PLWH [30.0 %] vs. controls [28.3 %], p = 0.86) or the combined therapy (p = 0.34). Among participants with established CV disease, only a third received an SGLT-2i and/or a GLP-1 RA (p = 0.63). Regarding quality of life, PLWH had more difficulties with self-care (p = 0.038) and there was a trend towards a greater burden of anxiety and depression (p = 0.051). PLWH and T2D in primary care received similar evidence-based therapies as controls, however, prescription rates in participants with CV disease were relatively low. Future studies with a larger sample size and longitudinal follow-up are needed to confirm the present findings.