Sodium-Glucose Cotransporter 2 Inhibitor Use in Patients with Heart Failure on the Rise

Strategic Insights -

New research from the University of New Mexico College of Pharmacy indicates that the utilization rate of sodium-glucose cotransporter 2 inhibitors (SGLT2is) in patients with heart failure has improved since 2021, but these agents continue to be underprescribed despite current guideline recommendations. The study, published in the American Journal of Health-System Pharmacy, evaluated prescribing patterns for SGLT2is from 2021 to 2023 in patients with heart failure and identified predictors of SGLT2i use.

Key Takeaways:

  • The utilization rate of SGLT2is in patients with heart failure increased from 6.5% in 2021 to 28.1% in 2023.
  • Patients with type 2 diabetes (T2D) were more likely to receive SGLT2is, with a prescribing rate of 45.9% compared to 12.4% in patients without T2D.
  • Predictors of SGLT2i prescribing included T2D, heart failure with reduced ejection fraction (HFrEF), visits with a pharmacist clinician, and a higher number of clinic visits.
  • The study concluded that SGLT2i utilization has improved, but these agents remain underprescribed in patients with heart failure, despite current guideline recommendations.

Statistics:

  • 395 patients were included in the study, with 148 having heart failure with reduced ejection fraction (HFrEF), 63 having heart failure with mildly reduced ejection fraction, and 184 having heart failure with preserved ejection fraction.
  • The mean age of patients was 68 years, with 44% being female and 54% being Hispanic.
  • SGLT2is were prescribed in 28.1% of patients overall, including in 45.9% of patients with T2D and 12.4% of patients without T2D.
  • The odds ratio for T2D as a predictor of SGLT2i prescribing was 4.29 (95% confidence interval, 2.42-7.6).
  • The odds ratio for HFrEF as a predictor of SGLT2i prescribing was 2.24 (95% confidence interval, 1.27-3.93).

Sources:

  • NewsRx. Researchers at University of New Mexico College of Pharmacy Target Type 2 Diabetes (Utilization rate and predictors of sodium-glucose cotransporter 2 inhibitor use in patients with heart failure: A continuing review). Cardiovascular Week. October 20, 2025; p 550.
  • American Journal of Health-System Pharmacy. Utilization rate and predictors of sodium-glucose cotransporter 2 inhibitor use in patients with heart failure: A continuing review. 2025.