There is limited US real-world evidence on changes in use of antihyperglycemic agents (AHA) by age in patients with T2D and CVD or CV risk. Patients with T2D and CVD or T2D and an additional CV risk factor were identified from 2015-2019 in the MarketScan data. Patients with continuous enrollment for the calendar year of the index date (first observed CVD diagnosis [Dx]/CV risk factor) and no CVD Dx before or in the same year as the index date (CV risk cohort only) were included. Patients were followed for each year they were continuously enrolled or until a CVD Dx (CV risk cohort). AHA classes received in each year were reported by cohort and age group (<65, ≥65). The CVD and CV risk cohorts included 693,910 (56% <65, 44% ≥65) and 1,244,610 patients (83% <65, 18% ≥65), respectively. Overall, patients receiving GLP-1 RAs and SGLT2is increased over time across both cohorts and age groups. For both cohorts, from 2015-2019, the percent of patients <65 on GLP-1 RAs increased from 9-17% and was approximately twice those ≥65 (4-8%), while the percent of patients <65 on SGLT2is increased (CVD:11-16%, CV risk:11-17%) and was approximately triple those ≥65 (CVD:3-6%, CV risk:4-7%). While the use of GLP-1 RAs and SGLT-2is increased during the study period, even in 2019, most patients with T2D and CVD or CV risk did not receive these cardioprotective medications and patients ≥65 years were particularly disadvantaged.
