Physician Views: Jardiance approved by FDA for reducing cardiovascular death in diabetes patients – what impact on treatment trends?

Late last week the FDA approved an expanded indication for Eli Lilly and Boehringer Ingelheim's SGLT-2 inhibitor Jardiance to include reducing the risk of cardiovascular death in adults with type 2 diabetes and cardiovascular disease.

The decision was backed by data from the post-marketing EMPA-REG OUTCOME study, which demonstrated that Jardiance, in combination with standard of care, significantly reduced the risk of cardiovascular death, non-fatal heart attack or non-fatal stroke versus placebo.

Analysts and key opinion leaders (KOLs) have reported an increase in the use of Jardiance since data from EMPA-REG OUTCOME was published more than a year ago. However, in June, an FDA advisory panel voted by a margin of 12 to 11 that there was "substantial evidence" showing Jardiance reduces the risk of cardiovascular death.

With a new indication formally approved, Eli Lilly and Boehringer Ingelheim can now promote the EMPA-REG OUTCOME data to US physicians. Key questions raised by FirstWord's interviews with KOLs concern what level of share gain Jardiance may assume from other SGLT-2 inhibitors, whether physicians perceive cardiovascular benefit to be a class effect and whether the SGLT-2 inhibitor class can gain significant share as a second-line therapy for type 2 diabetes as a result.

To better understand these dynamics in light of recent FDA approval, we are surveying US-based endocrinologists and primary care physicians with the following questions…

Which of the SGLT-2 inhibitors do you prefer to use for the management of type 2 diabetes?

Farxiga (dapagliflozin)

Invokana (canagliflozin)

Jardiance (empagliflozin)

I consider them to be equally efficacious/safe

None – I never prescribe SGLT-2 inhibitors

Last week, the FDA approved a new indication for the SGLT-2 inhibitor Jardiance to reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease. Approval was based on data from the EMPA-REG OUTCOME study.

Will approval of this new indication prompt you to increase your use of Jardiance at the expense of the other SGLT-2 inhibitors?

No –

Yes – slightly

Yes – moderately

Yes – significantly

Yes – very significantly

Will approval of this new indication prompt you to increase your use of Jardiance – or SGLT-2 inhibitors in general – as second-line therapies ahead of DPP-4 inhibitors?

No

Yes – slightly – SGLT-2 inhibitors in general

Yes – moderately – SGLT-2 inhibitors in general

Yes – significantly – SGLT-2 inhibitors in general

Yes – very significantly – SGLT-2 inhibitors in general

Yes – slightly – Jardiance specifically

Yes – moderately – Jardiance specifically

Yes – significantly – Jardiance specifically

Yes – very significantly – Jardiance specifically

Will your increased use of Jardiance, or SGLT-2 inhibitors in general, occur specifically in type 2 diabetes patients with established cardiovascular disease?

Never

Rarely

Sometimes

Often

Always

n/a

If one or both of the other SGLT-2 inhibitors (Invokana and Farxiga) delivers positive data from ongoing cardiovascular outcomes studies, do you think this would have a notable impact on overall usage of the SGLT-2 inhibitor class?

No

Yes – slightly

Yes – moderately

Yes – significantly

Yes – very significantly

Results and related analysis will be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions. Note: FirstWord Polls are powered by MedePolls, a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialties and over 100 markets. To conduct this poll with a different audience, or an entirely different poll, contact us at info@firstwordpharma.com

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