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Joanna Lewis, PharmD, MBA explores effective over-the-counter solutions for menstrual cramps, including NSAIDs, supplements, and tips for optimal relief.

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Check out these top featured stories from Drug Topics in April 2024.

In Depth Perspectives: Psychedelic Medicine, Scope Creep, And More

CVS and Walgreens will limit their offerings for the COVID-19 vaccine, even for those who meet the new criteria from the FDA, according to 

 The new criteria limit who can receive a COVID-19 vaccine, with 4 different vaccines having different indications on who can receive the immunization.

CVS will now offer COVID-19 vaccines in 13 of 16 states and the District of Columbia to those who have a prescription from their physician or other medical provider. The states include Arizona, Colorado, Florida, Georgia, Kentucky, Louisiana, Maine, North Carolina, New York, Pennsylvania, Utah, Virginia, and West Virginia. CVS will not offer COVID-19 vaccines in Massachusetts, Nevada, and New Mexico. According to 

, CVS will offer updated COVID-19 vaccines in the remaining states pending Advisory Committee on Immunization Practice (ACIP) guidelines. For Walgreens, patients need prescriptions for 16 states but not all of them overlap with CVS, and it is unclear which states include these 16, according to 

The FDA recently approved 4 updated COVID-19 vaccines: Pfizer and BioNTech’s Comirnaty, Novavax’s Nuvaxovid, and Moderna’s Spikevax and mNexspike. All have been approved for adults 65 years and older to prevent COVID-19. Other indications include

Nuvaxovid: for patients aged 12 years through 64 with at high risk of severe disease with least 1 underlying condition

Spikevax: for patients 6 months through 64 years at high risk of severe disease with at least 1 underlying condition

mNexspike: for patients aged 12 through 64 years at high risk of severe disease with at least 1 underlying condition

Comirnaty: for patients aged 5 through 64 years at high risk for severe disease with at least 1 underlying condition

Guidance and information on the upcoming 2025-2026 respiratory season have been met with confusion. Recommendations, which were once aligned across organizations, are now conflicting, which included government organizations, such as the CDC, as well as the health care organizations, such as the American Academy of Pediatrics (AAP). Pregnancy has been removed from the adult schedule, even though some health care providers consider it an underlying condition leading to severe disease.

“We need to take the politics out of immunizations and rely on medical experts with years of education, the experience, and the knowledge to interpret that data to provide evidence-based recommendations," Laura Knockel, PharmD, BCACP, clinical associate professor at the University of Iowa College of Pharmacy, said.

AAP published its annual immunization schedule, which covers guidance for influenza, respiratory syncytial virus, and COVID-19. Although recommendations from the organization typically follow ACIP guidelines, this year the schedule differs from the recent recommendations from the committee.

“[Patients are] understandably confused. The space around vaccines is changing so rapidly,” Knockel said.

 “There's so much misinformation and disinformation out there, so I really think the first step is to acknowledge that concern, and again, coming from the point of they want to do what's best for their child.”

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1. Astor M, Blum D. CDC uncertainty upends COVID vaccine access at CVS and Walgreens. 

. August 28, 2025. Accessed September 2, 2025. https://www.nytimes.com/2025/08/28/well/cvs-pharmacy-covid-vaccine-16-states.html

2. Levy S. CVS, Walgreens limiting offerings of new COVID-19 vaccines. 

. September 2, 2025. Accessed September 2, 2025. https://drugstorenews.com/cvs-walgreens-limiting-offerings-new-covid-19-vaccines

3. Gallagher A. FDA approves COVID-19 vaccines for patients 65 years and older. 

. August 23, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/fda-approves-covid-19-vaccines-for-patients-65-years-and-older

4. Gallagher A. New COVID-19 vaccine recommendations cause confusion among public, health care providers. 

. June 10, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/new-covid-19-vaccine-recommendations-cause-confusion-among-public-health-care-providers

5. Gallagher A, Knockel L. Q&A: pharmacist advocates for evidence-based immunization guidelines for COVID-19 vaccines. 

. September 1, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/q-a-pharmacist-advocates-for-evidence-based-immunization-guidelines-for-covid-19-vaccines

6. Gallagher A. FDA approves updated 2025-2026 COVID-19 vaccine for patients 65 years and older. 

. August 27, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/fda-approves-updated-2025-2026-covid-19-vaccine-for-patients-65-years-and-older

CVS will not offer COVID-19 vaccines in Massachusetts, Nevada, and New Mexico.

Clinical

CVS, Walgreens Will Limit COVID-19 Vaccine Offerings in 16 States

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 

 and get the latest drug information, industry trends, and patient care tips, straight to your inbox.

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.

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

Orforglipron, an investigational oral glucagon-like peptide-1 (GLP-1) receptor agonist from Eli Lilly, demonstrated significant weight loss, meaningful hemoglobin A

 reductions, and improvements in cardiometabolic risk factors at 72 weeks, according to results from the phase 3 ATTAIN-2 (

"Based on my experience leading clinical trials in obesity and diabetes, these data show the potential for orforglipron to offer an efficacy, safety, and tolerability profile consistent with the injectable GLP-1 class," Louis J. Aronne, MD, FACP, DABOM, founder and chair emeritus of the American Board of Obesity Medicine, said in a news release.

 "Orforglipron could help health care providers expand treatment options for patients who prefer oral therapies without compromising clinical results."

Investigators of the study determined the safety and efficacy of the oral treatment compared with the placebo for adults with obesity or overweight and type 2 diabetes. The trial lasted approximately 77 weeks and included up to 22 clinic visits, according to the clinical trial information. Patients included in the study had a body mass index of 27 kg/m

 or greater, at least 1 self-reported unsuccessful dietary effort to lose body weight, and a diagnosis of type 2 diabetes with a hemoglobin A

 level from 7% to 101% and were on stable treatment for at least 90 days prior to screening.

In the study, patients received 1 of 3 doses of orforglipron (6 mg, 12 mg, and 36 mg) or the placebo. The primary end point included mean percent change from baseline in body weight at week 72. Secondary outcomes included mean change from baseline in waist circumference, hemoglobin A

 fasting glucose level, systolic blood pressure, fasting triglycerides, fasting non–high-density lipoprotein cholesterol, fasting insulin, diastolic blood pressure, and Short Form 36 v2 Health Survey Acute form domain scores from baseline to week 72.

Investigators found that the primary end point was –5.5% for orforglipron 6 mg, 
–7.8% for 12 mg, and –10.5% for 36 mg compared with –2.2% for the placebo. For body weight reductions of 10% or more, 23.9%, 35.5%, and 50.1% of patients, respectively, achieved this compared with 7% taking the placebo. For reductions of 15% or more in body weight, 7.3%, 17.7%, and 28.4%, respectively, achieved this outcome compared with the placebo.

levels, patients receiving 6 mg, 12 mg, and 
36 mg achieved reductions from an average of 8.1% by –1.3%, –1.6%, and –1.8%, respectively, compared with –0.1% with the placebo. Approximately 70%, 78%, and 85.1% of patients, respectively, achieved a hemoglobin A

 level less than 7% compared with 23% on the placebo, and 56.2%, 67.5%, and 75%, respectively, achieved a 6.5% or lower hemoglobin A

As for safety, the drug was generally consistent with other drugs in the GLP-1 class, and most adverse events were gastrointestinal in nature, including nausea, vomiting, diarrhea, constipation, and dyspepsia.

The company previously announced positive results from the ATTAIN-1 (

) trial, showing that the therapy was efficacious and safe for weight loss in adults with overweight or obesity. In this study, the data showed that 59.6% of patients lost at least 10% of their body weight and 39.6% lost at least 15%.

1. Lilly's oral GLP-1, orforglipron, is successful in third phase 3 trial, triggering global regulatory submissions this year for the treatment of obesity. News release. Eli Lilly. August 26, 2025. Accessed September 3, 2025. https://investor.lilly.com/news-releases/news-release-details/lillys-oral-glp-1-orforglipron-successful-third-phase-3-trial

2. A study of orforglipron in adult participants with obesity or overweight and type 2 diabetes (ATTAIN-2). ClinicalTrials.gov. Updated April 17, 2025. Accessed September 3, 2025. https://clinicaltrials.gov/study/NCT05872620

3. Meara K. Oral GLP-1 orforglipron shows meaningful weight loss in phase 3 trial. 

. August 7, 2025. Accessed September 3, 2025. https://www.drugtopics.com/view/oral-glp-1-orforglipron-shows-meaningful-weight-loss-in-phase-3-trial

Orforglipron shows results in weight loss and diabetes management, offering a new oral treatment option for patients.

Drug Topics Staff

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