Trends of use of SGLT2 inhibitors in Qatar

Background: Type 2 diabetes mellitus (T2DM) represents a growing health challenge in Qatar and worldwide. T2DM is associated with a high risk of cardiovascular (CV) morbidity and mortality, and progression of renal disease. Sodium glucose co-transporter 2 inhibitors (SGLT2is) are the most recently approved class of glucose lowering medications (GLMs). To date, there is a limited knowledge about the adoption of SGLT2is by clinicians compared to other oral GLMs in Qatar and Middle East and North Africa (MENA) region. Accordingly, this proposed study aims to explore the trends in SGLT2is use compared to other oral GLMs in Qatar from 2016 to 2020. Methods: This is a descriptive, retrospective cross-sectional study where information on all oral GLMs prescriptions dispensed as in- or out-patient from 2016 to 2020 in all Hamad Medical Corporation (HMC) hospitals were collected. Outcomes included the number and relative frequency of quarterly prescriptions of different oral GLMs classes [metformin, sulfonylureas (SUs), dipeptidyl peptidase 4 inhibitors (DPP-4is), thiazolidinediones (TZDs), meglitinides (MEGs), α-glucosidase inhibitors (AGIs), and SGLT2is] from 2016 to 2020. Results: Overall, the prescription rate of GLMs increased during the last five years. SGLT2is use increased over the years after being introduced to the formulary in 2017, replacing SUs which exhibited significant decline between 2017 and 2020. There was a slight reduction in metformin use, and a slight increase in DPP-4is use. TZDs, MEGs, and AGIs prescriptions remained stable. Among SGLT2is, empagliflozin showed considerable increase on the expense of dapagliflozin which decreased significantly by the end of 2018. Conclusion: SGLT2is have been gradually replacing SUs in Qatar and the trend of their use is similar to that reported in other countries. The trend among SGLT2is suggests greater preference for empagliflozin over dapagliflozin.