{"id":"534ac0efd383","type":"article","url":"https://hartvaat.nl/2026/10/07/glp-1-remmers-en-sglt2-remmers-dispariteiten-in-voorschrift-en-toegang-tot-cardi/","title":"GLP-1-remmers en SGLT2-remmers: dispariteiten in voorschrift en toegang tot cardiorenale zorg","title_en":"Disparities in GLP-1RA and SGLT2i Uptake: a Systematic Review and an Equity-First Framework for Cardiovascular-Kidney-Metabolic Care.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Current cardiology reports","doi":"10.1007/s11886-026-02431-y","source_url":"https://doi.org/10.1007/s11886-026-02431-y","authors":["Andre H Chu","Boomer Olsen","Joshua Choi","Amara Sarwal","Farrant Sakaguchi","Farideh Akramimoghadam","Joshua A Jacobs","Deepika Reddy","Nikhil Bhatt","Oshozimhede Iyalomhe","Niharika Katkam","Matthew Wahl","Aarya Choudhary","Polina Kukhareva"],"significance":5,"published":"2026-10-15","source_date":"2026-10-07","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/digoxine-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/esc-richtlijn-hartfalen-2021/"],"congress":"","summary_en":"This systematic review synthesizes US evidence on disparities in the uptake of GLP-1 receptor agonists and SGLT2 inhibitors across cardiovascular, kidney, and metabolic conditions. Analysis of 100 studies reveals persistent inequities, with Black and Hispanic patients, those on Medicaid, lower-income individuals, and older adults consistently experiencing lower prescribing rates despite guideline recommendations. The authors propose an Equity-First Framework to address structural, health-system, and patient-level barriers to pharmacoequity. For clinicians and health systems, the findings underscore the need for proactive patient identification, standardized care pathways, and continuous equity monitoring to ensure eligible patients actually receive these proven therapies.","created":"2026-10-08T01:14:45Z","updated":"2026-10-08T01:14:45Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze systematische review analyseert de beschikbare Amerikaanse literatuur (2013-2026) over dispariteiten in het voorschrijven van GLP-1-remmers en SGLT2-remmers bij patiënten met cardiorenale en metabole aandoeningen. Zwarte en Hispanische patiënten, mensen met een lagere inkomensgroep, Medicaid-verzekeringden en ouderen worden aanzienlijk minder vaak behandeld, ondanks de bewezen cardiovasculaire en nierbeschermende effecten. De auteurs stellen een Equity-First Framework voor om structurele, organisatorische en patiëntgerelateerde barrières aan te pakken en de farmacotherapeutische gelijkwaardigheid te verbeteren. Voor clinici in de eerste lijn en cardiologie is dit een belangrijke aanzet om zorgpaden te evalueren op toegankelijkheid en om dispariteiten actief te monitoren.","abstract_original":"PURPOSE OF REVIEW: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) improve cardiovascular, kidney, and metabolic outcomes, but equitable access remains a major challenge. This review synthesizes U.S. evidence on disparities in their use and proposes an Equity-First Framework for cardiovascular-kidney-metabolic care to advance pharmacoequity. RECENT FINDINGS: Across 100 U.S.o studies published from 2013 to 2026, the most consistent inequities involved race and ethnicity, socioeconomic status, insurance coverage, age, and access to specialty care, while geographic and sex-related patterns were more heterogeneous. Black and Hispanic patients, Medicaid beneficiaries, lower-income populations, and older adults frequently experienced lower prescribing or initiation. Although use increased following landmark trials and guideline updates, uptake remained well below the eligible population, and disparities persisted or widened for some newer agents. Barriers spanned societal and policy, health-system, provider, patient, and therapy-related domains. Achieving pharmacoequity will require coordinated, multilevel implementation. Our framework links equity-relevant factors and implementation determinants to actionable strategies, including equity monitoring, identification and engagement of eligible patients, equitable care pathways, reduction of structural access barriers, and support for clinicians and patients."}