Matthew Budoff, MD: Need for Greater Uptake of Newer Medications


Matthew Budoff, MD, discusses what he views as hurdles to achieving optimal prescription of newer agents in the treatment of cardiometabolic conditions, including diabetes, heart failure, dyslipidemia, and more.

One of the most prominent discussions occurring at The Metabolic Institute of America’s (TMIOA) 2021 5th Heart in Diabetes sessions in New York, NY, centered around subpar uptake of newer medications, among endocrinologists, cardiologists, and other providers.

Much of this discussion was related to advancing role of SGLT2 inhibitors and GLP-1 receptor agonists in the treatment of patients with diabetes and other cardiometabolic conditions, such as chronic kidney disease and heart failure.

This role, Matthew Budoff, MD, explained, is one that is being stalled by regulatory processes. In the second segment of an interview with our sister publication HCPLive at the meeting, Budoff, professor of medicine at David Geffen School of Medicine at UCLA, explained why the real-world uptake of newer cardiometabolic agents lags behind despite proven efficacy in clinical trials.

In this interview, Budoff explained, the US operates on a “general rule” that findings from 2 randomized trials may constitute a class I indication for a drug class. For example, he said, the DAPA-HF and EMPEROR trials supported the use of SGLT2 inhibitors for the reduced risk of heart failure in patients with and without diabetes. Budoff cited the CANVAS and EMPA-REG trials as supporting the drug class’ benefit in reducing composite cardiovascular death in patients with diabetes and atherosclerotic cardiovascular disease. Budoff went on to cite a trio of randomized clinical trials support GLP-1 receptor agonists for the reduction of composite coronary events, stroke, and all-cause death, he said.

For more on this topic, check out the video interview below:

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