Year: 2026 | Month: February | Volume: 16 | Issue: 2 | Pages: 411-419
DOI: https://doi.org/10.52403/ijhsr.20260247
Navigating Therapeutic Choice Within a Class: SGLT2 Inhibitor Practice Patterns Across Cardiovascular Indications
Mohod B. A.1, Mayabhate M. M.2, Sharma A. D.3
1,2,3Medical Affairs, Alkem Labs Mumbai, Maharashtra, India
Corresponding Author: Dr. Bhagyashree Mohod
ABSTRACT
Background: Sodium–glucose cotransporter-2 inhibitors (SGLT2i) have evolved from glucose-lowering therapies to integral agents in cardiovascular and renal disease management. However, factors influencing physician selection within this therapeutic class remain incompletely understood. This study evaluated cardiologist prescribing preferences regarding SGLT2 inhibitor use across cardiovascular indications.
Methods: A cross-sectional survey was conducted among cardiologists attending the Cardiological Society of India conference. An 11-item structured questionnaire assessed prescribing patterns, decision drivers, and perceptions of comparative efficacy and safety across cardiovascular, renal, and heart failure scenarios. Participation was voluntary and anonymous. Responses from 100 cardiologists were analysed descriptively and reported as percentages.
Results: Empagliflozin was preferred in routine practice by 51% of respondents compared with 27% favouring dapagliflozin, while 17% reported equivalence, suggesting variability in therapeutic selection. Cardiovascular mortality reduction was the leading decision driver (42%), followed by major adverse cardiovascular event reduction and heart failure hospitalization reduction (31% each). In CKD without diabetes, 40% preferred empagliflozin, 24% dapagliflozin, and 28% reported equivalence; confidence in low eGFR settings favored empagliflozin in 53% of responses. In HFpEF, symptomatic benefit was attributed to empagliflozin by 39%, dapagliflozin by 18%, and 39% reported similar benefit, reflecting mixed perceptions of class effects. For ASCVD secondary prevention, empagliflozin was preferred by 45% versus 17%, and 67% favoured it when early post-MI initiation was considered. Safety perceptions were similar between agents.
Conclusion: Cardiologist prescribing preferences for SGLT2 inhibitors appear shaped by interpretation of outcome evidence and clinical context rather than uniform differentiation within the class. Continued comparative research and balanced dissemination of evidence may enhance consistency in therapeutic positioning and translation of trial findings into practice. These findings reflect perception-based preferences rather than comparative clinical efficacy
Key words: SGLT2 inhibitors; Cardiovascular outcomes; Heart failure; chronic kidney disease; Prescribing patterns