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The approved vaccines include Novavax’s Nuvaxovid and Moderna’s Spikevax and mNexspike.

FDA Approves COVID-19 Vaccines for Patients 65 Years and Older

The approval covers Pfizer and BioNTech’s LP.8.1-adapted monovalent COVID-19 vaccine, which is also indicated for patients aged 5 to 64 with at least 1 underlying condition.

FDA Approves Updated 2025-2026 COVID-19 Vaccine for Patients 65 Years and Older

Through considerations regarding cost, scalability, safety, and regulations, researchers provided an end-to-end perspective on microneedle-based vaccine strategies.

Microneedle-Based Vaccine Systems Emerging as Viable Future Option

Pharmacies face time, workload, and sustainability challenges when integrating social care, but support and reimbursement can make these efforts viable.

Q&A: Addressing Barriers to Social Care in Pharmacies

Drug Topics connects pharmacists across retail, health system, and specialty practice with clinical updates, pharmacy trends, and regulatory news.

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Social media marketing is a powerful tool that pharmacists can use. 

Do’s And Don’ts: Social Media Tips for Pharmacists

journal explores issues within pharmacy, from the impact advocacy can have in community pharmacies to staffing shortages across multiple sectors within pharmacy. This month’s issue also explored the importance of disease awareness months and how they are opportunities to maximize valued care. Check out a preview of this month’s issue here.

download the PDF of the Total Pharmacy August 2024 issue here

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See what’s trending in pharmacy with a preview of the Total Pharmacy August issue.

Total Pharmacy

In This Issue: Total Pharmacy August 2024

Combining sodium glucose co-transporter 2 inhibitors (SGLT2is) with glucagon-like peptide-1 receptor agonists (GLP-1RAs) may offer additional protection against cardiovascular and kidney disease in patients with type 2 diabetes (T2D), according to the results of a new meta-analysis published in 

 and presented at the 61st European Renal Association Congress in Stockholm, Sweden.

Separately, SGLT2is and GLP-1RAs have demonstrated cardiovascular benefits. However, little clinical literature has focused on outcomes associated with using the medicines together. Due to the growing prevalence of GLP-1RAs in the 

 and obesity landscape, accelerated by an increasing number of indications for the agent class, this is a crucial area for further study.

The SGLT2 Inhibitor Meta-analysis Cardio-Renal Trialists’ Consortium (SMART-C) is the largest assessment of outcomes for the combined therapeutic use of SGLT2is and GLP-1RAs. The study gathered data from 12 large-scale, placebo-controlled trials of SGLT2is involving 73,238 patients with diabetes. Of these, 3065 were already receiving GLP-1RAs.

Overall, SGLT2is lowered the risk of major adverse cardiovascular events by 11% and hospitalization for heart failure or cardiovascular death by 23% compared to placebo. Notably, this benefit was seen regardless of whether patients were also taking GLP-1RAs.

When used together with GLP-1RAs, SGLT2is reduced the risk of chronic kidney disease progression by 33% and slowed the annual loss of kidney function by nearly 60%.

The study found no additional safety concerns when SGLT2is were used in combination with GLP-1RAs.

Study Reveals Robust Benefits of Semaglutide in Protecting Against Kidney, CV Events in Patients With T2D

Current meta-analysis results build off positive results of the landmark FLOW trial (

). Published earlier in May, results of the international, double-blind, randomized, placebo-controlled phase 3 trial spotlighted semaglutide’s effectiveness in lowering the risk of kidney failure, decelerating worsening kidney function, and protecting against the risk of cardiovascular events and death, in patients with T2D.

“SGLT2 inhibitors have clear protective effects against heart failure and chronic kidney disease, while GLP-1 receptor agonists can reduce the risk of heart attack, stroke, and also kidney disease—as recently demonstrated in the landmark FLOW trial,” said Brendon Neuen, lead author, clinical associate professor, senior research fellow at The George Institute for Global Health, and director of kidney trials at Sydney’s Royal North Shore Hospital, in a news release.

 “Our findings support using this combination to further improve outcomes in patients with type 2 diabetes who meet guideline recommendations for both therapies.”

Elevated glucose from diabetes can damage blood vessels in the heart and kidneys, increasing the risk of 

 and kidney disease. In fact, diabetes is the most common cause of chronic kidney disease.

Moreover, estimates predicting that T2D prevalence will more than double in the next 30 years, surpassing 1 billion global cases by 2050, further strengthen the need for research into diabetes care.

 According to Neuen in an interview with 

 conducted over email, the current study offers valuable insights for developing global treatment strategies for the condition.

"These findings, which represent the largest and most comprehensive evaluation of the combined use of SGLT2i and GLP-1RA, provides the clearest evidence yet that combined use of both medicines can further reduce cardiovascular and kidney disease," said Neuen. "We anticipate that these findings will inform how people with diabetes are treated worldwide, including influencing major clinical practice guidelines.

Although current results suggest that using SGLT2is and GLP-1RAs in tandem may offer robust protection against cardiovascular and kidney disease, further research is needed to fully understand the long-term effects of the combination therapy.

Pharmacy practice is always changing. Stay ahead of the curve: Sign up for our 

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1. Apperloo E, Neuen BL et al. Efficacy and safety of sodium glucose co-transporter 2 inhibitors with and without glucagon-like peptide-1 receptor agonists: A SMART-C collaborative meta-analysis of randomised controlled trials. 

. 2024. doi: 10.1016/S2213-8587(24)00183-9

2. Massaro L. Study reveals robust benefits of semaglutide in protecting against kidney, CV events in patients with T2D. 

https://www.drugtopics.com/view/study-reveals-robust-benefits-of-semaglutide-in-protecting-against-kidney-cv-events-in-patients-with-t2d

3. Combining popular diabetes drugs offers complementary heart and kidney benefits. News release. The George Institute for Global Health. July 9, 2024. Accessed July 10, 2024. 

https://www.georgeinstitute.org/media-releases/combining-popular-diabetes-drugs-offers-complementary-heart-and-kidney-benefits

4. Mayo Clinic Staff. Chronic kidney disease. Fact sheet. Accessed July 8, 2024. 

https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521

5. Klein HE. Diabetes prevalence expected to double globally by 2050. 

https://www.ajmc.com/view/diabetes-prevalence-expected-to-double-globally-by-2050

When used together, sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) were able to lower the risk of major adverse cardiovascular events and kidney disease by 11% and 33%, respectively.

Clinical

SGLT2i, GLP-1RA Combination Therapy Offers Robust Protection Against Cardiovascular, Kidney Disease

Despite no existing respiratory syncytial virus (RSV) vaccine reserved for infants, maternal vaccines have demonstrated longer protection than monoclonal antibodies (mAbs), according to data from a study published in the 

“RSV is a prevalent cause of upper respiratory tract infections (URTI), and can progress to lower respiratory tract infections (LRTI), particularly in vulnerable groups, such as infants, immunocompromised individuals, and [older people],” wrote authors of the study. “Beyond causing immediate illness, RSV infections in infancy have been linked to persistent wheezing and the long-term development of asthma.”

For infants, their mothers, and the providers who care for them, RSV is one of the most challenging health-related complications they face. According to findings of a study in 

, RSV-related LRTI are responsible for up to 3 million hospitalizations and 120,000 deaths each year among children under 5.

Pharmacist, Provider Partnership Can Help Increase RSV Vaccine Uptake

Previous evidence shows that the most at-risk populations when it comes to RSV, URTI, and LRTI are infants and adults aged 65 or older. Although the older population has 3 RSV vaccine formulations available—Abrysvo, Arexvy, or Mresvia—the RSV antibody nirsevimab for children younger than 8 months is the frontline option for keeping them protected against LRTI and URTI.

Authors of the current study and CDC recommendations have supported evidence that mothers who receive the RSV vaccine can pass antibodies to their newborns, providing protection against RSV for up to the child’s first 6 months.

“Immunization is a key approach for protecting infants and children against RSV,...whether it is passive immunization via mAbs and maternal antibodies or active immunization via RSV vaccination,” they continued.

 “This narrative review aims to critically compare various immunization methods for children against RSV, discussing the strengths, limitations, and future directions of each.”

In over 50 years of vaccine development, researchers have persistently failed to bring an RSV vaccine to market for protection among infants. With no methods of keeping one of the more at-risk populations protected, researchers later developed palivizumab as a mAb option available for infants. In 2023, the FDA approved nirsevimab for its similar effects among infants, but its availability is known to be limited.

“Palivizumab’s use is confined to a narrow segment of the pediatric population—those under 35 weeks of gestational age and those up to 6 months of age at the RSV season's onset, along with individuals with specific underlying conditions,” wrote the authors.

 “Consequently, most infants remain unprotected against RSV. Therefore, protecting all infants up to 6 months of age is only possible through maternal immunization or using extended-duration mAbs.”

Maternal immunization, or transplacental antibody transfer, would be the alternative option for parents choosing not to directly vaccinate their infants with mAbs. And as a significant amount of evidence suggests, this may be the best option for protecting children against RSV. If timed right, toward the end of pregnancy, a mother receiving the RSV vaccine could provide the strongest protection for infants during their first, most vulnerable 6 months of life.

At present, the best method of maternal immunization is to vaccinate mothers between 32 and 36 weeks with Pfizer's bivalent RSVpreF vaccine (Abrysvo). However, despite this being the currently accepted approach for maternal immunization among children, many uncertainties persist regarding antibody detection and the effects of the vaccine on mothers or their newborns.

Amid competing options for helping infants avoid RSV, researchers compared the 2 methods.

“Despite years of investigation, a dedicated RSV vaccine for children remains unavailable. However, recent FDA approval of maternal RSV vaccines has shifted the paradigm, as these vaccines provide longer-duration protection to infants compared [with] mAbs,” they wrote.

 “Current guidelines recommend that if a mother receives the RSV vaccine during pregnancy, the infant from that pregnancy may not require mAbs.”

While recent developments of maternal RSV vaccines have exhibited continued success among infants, researchers still believe a personalized approach for mothers and their newborns is necessary. Despite maternal vaccines potentially demonstrating better efficacy than mAbs, insurance coverage, past RSV experiences, health care access, provider counsel, and existing RSV knowledge all play significant roles as factors influencing a mother’s choice to vaccinate.

As of January of this year, according to CDC data, 38% of pregnant women in the US were vaccinated against RSV, leaving a large majority of expected newborns with no protection against the virus upon birth.

 Investigators of other studies have reported that overall protection against RSV among infants was about 55.8%, with 44.6% receiving the nirsevimab antibodies.

Amid continual research and development, providers have yet to accept one universal approach in protecting newborn infants against RSV. And with large numbers of pregnant women failing to seek protection for their children, providers are tasked with navigating the various guidelines and determining which recommendations to provide to specific patients.

Researchers hope the current study can better inform further developments of RSV vaccination strategies within this significantly at-risk population.

“Further clinical research is necessary to comprehensively compare the safety, efficacy, cost-effectiveness, and disease burden between infants whose mothers received the RSV vaccine and those whose mothers received mAbs,” concluded the authors.

 “This study will contribute to a more informed and evidence-based approach to RSV immunization strategies for infants and children.”

Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our 

1. Ali A, Shamim L, Ibrahim A, et al. Maternal respiratory syncytial virus (RSV) vaccination: current status and comparison to monoclonal antibodies (mAbs) for RSV prevention in infants and children. 

. Published online August 15, 2025:93-100. 

doi:10.34763/jmotherandchild.20252901.d-25-00012

2. Baraldi E, Checcucci Lisi G, Costantino C, et al. RSV disease in infants and young children: can we see a brighter future? 

. 2022;18(4):2079322. doi:10.1080/21645515.2022.2079322

3. Respiratory syncytial virus (RSV): the disease, vaccines & monoclonal antibody. Children’s Hospital of Philadelphia. August 4, 2025. Accessed August 18, 2025. 

https://www.chop.edu/vaccine-education-center/vaccine-details/rsv-vaccine-monoclonal-antibody

4. Immunizations to protect infants. CDC. August 30, 2024. Accessed August 18, 2025. 

https://www.cdc.gov/rsv/vaccines/protect-infants.html

5. Respiratory syncytial virus (RSV) vaccination coverage, pregnant women, United States. CDC. April 9, 2025. Accessed August 18, 2025. 

https://www.cdc.gov/rsvvaxview/dashboard/pregnant-women-coverage.html

6. Soucheray S. Only 56% of US infants protected by RSV vaccine, antibody. University of Minnesota. September 30, 2024. Accessed August 18, 2025. 

https://www.cidrap.umn.edu/respiratory-syncytial-virus-rsv/only-56-us-infants-protected-rsv-vaccine-antibody-0

Amid multiple methods for protecting children against RSV, researchers explored the strengths, limitations, and future approaches of each.

Maternal RSV Vaccine Shows Improved Protection Among Infants

Pharmacists play a key role in guiding patients on GLP-1 and dual agonist therapies, supporting safe use, managing side effects, and promoting long-term treatment success.

Wicked Good Cardiometabolic Chat: Practical Counseling Tips for GLP-1, Dual Agonist Therapies

In Wicked Good Cardiometabolic Chat, a podcast offering from 

, hosts Jennifer Goldman, PharmD, CDCES, BC-ADM, FCCP, professor of pharmacy practice at Massachusetts College of Pharmacy and Health Sciences (MCPHS); and Hailey Choi, PharmD, BCACP, CDCES, associate professor of pharmacy practice at MCPHS, aim to empower pharmacists with evidence-based insights on various cardiometabolic topics.

In this episode, Jen and Hailey explore practical counseling strategies for glucagon-like peptide-1 (GLP-1) receptor agonists and dual GIP/GLP-1 receptor agonists, with a focus on how pharmacists can effectively support patients using these therapies. Medications such as semaglutide and tirzepatide, better known by brand names including Ozempic, Wegovy, Mounjaro, and Zepbound, are increasingly used in the management of type 2 diabetes and obesity, making pharmacist counseling more important than ever.

Key discussion points include proper injection technique, storage recommendations, and strategies to manage common adverse effects such as nausea, constipation, and diarrhea. They share practical tips for improving adherence, such as linking the weekly injection to a memorable routine or helping patients pay attention to signals of fullness.

The discussion also covers critical safety considerations, including rare but serious risks such as pancreatitis, gallbladder disease, and vision changes. Other important counseling areas include contraceptive guidance, perioperative management, and strategies to maintain muscle health and overall nutrition. Patients should understand that these medications are intended for long-term therapy, and consistent pharmacist support is essential to achieving the best outcomes.

By equipping pharmacists with these practical tools and guidance, they can play a central role in patient success, helping patients safely use GLP-1 and dual agonist therapies while maximizing both short-term and long-term cardiometabolic benefits.

 for insightful conversations around different cardiometabolic topics that will help improve your practice and patient care. All episodes of Wicked Good Cardiometabolic Chat will be available in video via 

, with an audio version available through Spotify.

Pharmacists play a key role in guiding patients on GLP-1 and dual agonist therapies, supporting safe use, managing adverse effects, and promoting long-term treatment success.

Bridget Hanna, CPhT

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