Introduction and Objective: To assess prevalence and factors for treatment failure with SGLT2i in US adults with T2D.Methods: This was a retrospective cohort study among US adults with T2D who initiated SGLT2i between January 1, 2016 and April 30, 2024, using the Komodo Healthcare MapTM database. Treatment failure occurred if they discontinued SGLT2i, added or switched to another glucose-lowering therapy, or had consecutive HbA1c ≥8% without treatment changes. Time to SGLT2i failure was assessed using cumulative incidence functions. Factors for failure were identified using Cox models. Lastly, incidence of T2D complications and healthcare resource utilization (HCRU) were described.Results: Out of 237,295 new SGLT2i users, 183,485 (77.3%) experienced treatment failure over an average follow-up time of 34 months. The median time to failure was 9.14 months. Risk factors for failure included age ≥75, comorbidities such as hypertension, and experiencing common T2D-related adverse events such as hypoglycemia leading to ER or hospitalization. Lastly, high incidence of T2D complications and HCRU were observed with SGLT2i failure.Conclusion: The study revealed high prevalence and burden of treatment failure with SGLT2i, suggesting the need for timely treatment adjustment for the high-risk population who do not achieve optimal treatment benefit with SGLT2i.
X. Tan: Employee; Novo Nordisk. Y. Cao: None. Y. Wang: Other Relationship; Analysis Group, Inc. J.M. Boland: None. M. Guevarra: Employee; Novo Nordisk. L. Xie: None. Y. Song: Research Support; Novo Nordisk. M.N. Kwak: Consultant; Novo Nordisk, Endocrine & Diabetes Plus Clinic of Houston.
The study was funded by Novo Nordisk, Inc.
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