Recent UK type 2 diabetes treatment guidance represents a near whole population indication for SGLT2-inhibitor therapy
dc.contributor.author | Young, KG | |
dc.contributor.author | Hopkins, R | |
dc.contributor.author | Shields, BM | |
dc.contributor.author | Thomas, NJ | |
dc.contributor.author | McGovern, AP | |
dc.contributor.author | Dennis, JM | |
dc.date.accessioned | 2023-11-16T14:27:39Z | |
dc.date.issued | 2023-11-02 | |
dc.date.updated | 2023-11-16T13:15:30Z | |
dc.description.abstract | Recent type 2 diabetes guidance from the UK's National Institute for Health and Care Excellence (NICE) proposes offering SGLT2-inhibitor therapy to people with established atherosclerotic cardiovascular disease (ASCVD) or heart failure, and considering SGLT2-inhibitor therapy for those at high-risk of cardiovascular disease defined as a 10-year cardiovascular risk of > 10% using the QRISK2 algorithm. We used a contemporary population-representative UK cohort of people with type 2 diabetes to assess the implications of this guidance. 93.1% of people currently on anti-hyperglycaemic treatment are now recommended or considered for SGLT2-inhibitor therapy under the new guidance, with the majority (59.6%) eligible on the basis of QRISK2 rather than established ASCVD or heart failure (33.6%). Applying these results to the approximately 2.20 million people in England currently on anti-hyperglycaemic medication suggests 1.75 million people will now be considered for additional SGLT2-inhibitor therapy, taking the total cost of SGLT2-inhibitor therapy in England to over £1 billion per year. Given that older people, those of non-white ethnic groups, and those at lower cardiovascular disease risk were underrepresented in the clinical trials which were used to inform this guidance, careful evaluation of the impact and safety of increased SGLT2-inhibitor prescribing across different populations is urgently required. Evidence of benefit should be weighed against the major cost implications for the UK National Health Service. | en_GB |
dc.description.sponsorship | Medical Research Council (MRC) | en_GB |
dc.description.sponsorship | Research England | en_GB |
dc.description.sponsorship | National Institute for Health and Care Research (NIHR) | en_GB |
dc.format.extent | 302- | |
dc.format.medium | Electronic | |
dc.identifier.citation | Vol. 22(1), article 302 | en_GB |
dc.identifier.doi | https://doi.org/10.1186/s12933-023-02032-x | |
dc.identifier.grantnumber | MR/N00633X/1 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/134566 | |
dc.identifier | ORCID: 0000-0003-2570-3864 (Young, Katherine G) | |
dc.identifier | ORCID: 0000-0003-3785-327X (Shields, Beverley M) | |
dc.identifier | ORCID: 0000-0002-6833-9399 (McGovern, Andrew P) | |
dc.identifier | ORCID: 0000-0002-7171-732X (Dennis, John M) | |
dc.language.iso | en | en_GB |
dc.publisher | BMC | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/37919773 | en_GB |
dc.rights | © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data | en_GB |
dc.subject | Cardiovascular disease | en_GB |
dc.subject | Diabetes mellitus type 2 | en_GB |
dc.subject | SGLT2-inhibitors | en_GB |
dc.title | Recent UK type 2 diabetes treatment guidance represents a near whole population indication for SGLT2-inhibitor therapy | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2023-11-16T14:27:39Z | |
dc.identifier.issn | 1475-2840 | |
exeter.article-number | 302 | |
exeter.place-of-publication | England | |
dc.description | This is the final version. Available on open access from BMC via the DOI in this record | en_GB |
dc.description | Availability of data and materials: Requests to access data provided by Clinical Practice Research Datalink (CPRD) should be directed to CPRD. | en_GB |
dc.identifier.eissn | 1475-2840 | |
dc.identifier.journal | Cardiovascular Diabetology | en_GB |
dc.relation.ispartof | Cardiovasc Diabetol, 22(1) | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2023-10-13 | |
dc.rights.license | CC BY | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2023-11-02 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2023-11-16T14:25:51Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2023-11-16T14:27:48Z | |
refterms.panel | A | en_GB |
refterms.dateFirstOnline | 2023-11-02 |
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