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Articles

After the certification of a new stroke center in respective communities, researchers compared the stroke outcomes of Black patients with those of White patients.

Despite Increase in Certified Stroke Centers, Racial Disparities Persist 

Since the COVID-19 pandemic, pharmacists are reevaluating career paths and calling for greater flexibility, support, and opportunities for professional growth.

Q&A: New Career Priorities Emerge for Pharmacists After COVID-19

In the study, tirzepatide (Mounjaro) improved measures of A1c, weight, renal function, and all-cause mortality.

Tirzepatide Shows Noninferiority to Dulaglutide for Rate of MACE

Videos

Hashim Zaibak, PharmD, CEO of Hayat Pharmacy, discusses the ongoing narratives surrounding vaccine hesitancy as well as his thoughts on the best ways of addressing the phenomenon.  

Pharmacy Training Crucial for Addressing Distrust in Vaccines

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

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Founder and CEO of Hayat Pharmacy in southeastern Wisconsin

Hashim Zaibak, PharmD, CEO of Hayat Pharmacy, discussed how immunization services at his pharmacy locations have evolved since the COVID-19 pandemic. 

Q&A: Community Pharmacies Help Increase Immunization Convenience, Uptake

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.

Clinical

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

Public trust in vaccination is at some of the lowest points in history.

Pharmacist Discusses Concerns Over Immunization Changes

Laura Knockel, PharmD, BCACP, a clinical associate professor at the University of Iowa College of Pharmacy, discusses the challenges health care providers face in communicating accurate vaccine information in an increasingly complex and fragmented information landscape. Knockel highlights growing concerns over how vaccine recommendations are being communicated, noting a shift away from traditional, transparent discussions to less formal channels such as social media posts.

To address this challenge, she recommends that health care professionals and patients rely on reputable sources such as professional organizations like the American Academy of Paediatrics and the Infectious Diseases Society of America. These organizations are increasingly developing robust vaccine resources that are accessible to the public, prioritizing the distribution of evidence-based recommendations.

Knockel also emphasizes the importance of vaccine safety and accessibility. She notes that vaccines undergo more rigorous testing than most medications due to their administration to healthy populations, and the US vaccine safety program is exceptionally robust. However, potential changes in the Advisory Committee on Immunization Practices recommendations could have significant implications for vaccine access and public health. Specifically, Knockel warns that narrowing vaccine recommendations could lead to patients paying out of pocket for vaccines, potentially discouraging vaccination and even impacting vaccine manufacturing.

Ultimately, she calls for continued education, staying informed about vaccine policy changes, and maintaining a focus on communicating the value of vaccines to patients. Despite the overwhelming nature of constant updates, health care providers must remain committed to keeping patients informed and healthy.

"What's happening with vaccine policy at the federal level is irresponsible at best and, I would say, extremely dangerous at worst and can be overwhelming, especially when pharmacists have so many other demands on their time to try to keep track of all these updates that keep coming out," Knockel said. "I really think we need to stay up to date, focus[ing] on educating the public and letting the patient, our patients, know the value of vaccines, and hopefully we can continue to keep our patients healthy."

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Laura Knockel, PharmD, BCACP, expresses concerns about how vaccine recommendations are being communicated, noting a shift away from traditional, transparent discussions to less formal channels such as social media.

Pharmacist Discusses Concerns Over Immunization Changes, Public Trust

Hispanic and Black children were disproportionately hospitalized and more likely to experience severe symptoms from COVID-19 compared with White, Asian, or Pacific Islander patients, according to study data published in 

The researchers’ findings highlight a need for increasing equitable access to therapies and vaccines for COVID-19.

“Since the start of the COVID-19 pandemic in 2020, most hospitalizations for COVID-19 have occurred among adults, and [data from] multiple studies demonstrated that COVID-19 hospitalizations disproportionately affected and exacerbated existing health disparities among adults of racial and ethnic minority populations, with hospitalization rates more than 5-fold higher among Black and Hispanic populations [than] White adult populations in 2020,” wrote the study authors.

Although severe COVID-19 infection was most prominent among older adults, it also occurred among children throughout the pandemic’s peaks. According to the American Academy of Pediatrics'

, around 234,000 children under 18 were hospitalized with COVID-19 between fall 2020 and spring 2024.

Increased COVID-19 Testing Skewed Understanding of Respiratory Disease Trends

During the formative days of the pandemic in 2020 and 2021, the older adult population was the main focus of public health experts. Although the first COVID-19 vaccine approval in August 2021 included anyone aged 16 or older,

 it was reserved for older adults, as the first 2 recipients were a 90-year-old woman and an 81-year-old man.

It wasn’t until late in 2021 that younger children began receiving approval for COVID-19 vaccines. Those aged 5 to 11 years received approval in November that year, and children 6 months to 5 years received approval in June 2022.

“Although [findings from] a 2022 report demonstrated that disparities in hospitalizations by race and ethnicity also occurred among pediatric populations, few studies have examined these disparities over the course of the pandemic,” continued the authors.

 “This analysis examines observed racial and ethnic disparities and outcomes among children hospitalized with COVID-19 from March 2020 to September 2023.”

Throughout this time frame, researchers explored Coronavirus Disease 2019  Hospitalization Surveillance Network (COVID-NET) data from over 13,000 hospitalizations of patients 17 years or younger with lab-confirmed SARS-CoV-2 infection. All participants resided in 12 states that were part of COVID-NET catchment areas, consisting of an estimated 10% of the US population.

In addition to providing patients’ age, sex, race, and ethnicity, researchers also separated age groups and time periods in the study. To better understand hospitalization rates, they separated pediatric age groups into children 12 to 17, 5 to 11, and those 4 or under. Time periods were separated into 4, beginning with March to December 2020, October 2020 to September 2021, October 2021 to September 2022, and October 2022 to September 2023.

The final analysis included 13,555 COVID-19–related pediatric hospitalizations (the median age of patients was 3.3 years, and 52.5% of them were boys).

“Cumulative and weekly hospitalization rates from March 2020 to September 2023 overall indicated that Hispanic and Black children were disproportionately hospitalized compared with their Asian or Pacific Islander and White peers,” they wrote.

 “COVID-19–associated hospitalization rates were consistently highest among Black and Hispanic children aged 17 years or younger and among all age groups.”

Based on COVID-NET data, Black children experienced the highest rates of hospitalizations from COVID-19 during this time, whereas Asian or Pacific Islander children had the lowest rates. Indeed, rates were 2.15 times higher for Black children and 2.06 times higher for Hispanic children than those of Asian or Pacific Islander groups.

Furthermore, the researchers noted the highest rates of intensive care unit (ICU) visits were 1.88 times higher for Black patients and 2.13 times higher for Hispanic patients. Finally, among the hospitalized children, 61.4% of those who were Black had at least 1 underlying medical condition. For Hispanic, White, and Asian or Pacific Islander children, however, the researchers reported at least 1 underlying condition in under 46% of each population.

“These disparities were evident early [on] in the pandemic and persisted over multiple years,” the authors continued. “Although hospitalization and ICU admission rates decreased during the period from October 2022 to September 2023 compared with earlier surveillance periods, both were highest among Black and Hispanic children, with rates nearly twice those among Asian or Pacific Islander children.”
Similar to many other areas of health care and social spaces in the US, racial disparities persist. With minority groups being more at risk yet receiving under-valued care, they are treated disproportionately when compared with their White counterparts. This reality has been reinforced by both the current study findings and the ongoing data from COVID-19– and pandemic-related literature—all highlighting the failure of the health care field to combat racial inequities.

“This study found that among pediatric patients hospitalized with COVID-19, Black and Hispanic children were disproportionately more likely to be hospitalized for COVID-19 and experience severe disease [than] White and Asian or Pacific Islander children,” concluded the authors.

 “[The data from] this study underline the need for targeted interventions, particularly for children with underlying medical conditions, and the need for equitable access and use of vaccines and therapeutics for disproportionately affected populations.”

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

1. Anglin O, Patel K, Daily Kirley PD, et al. Pediatric COVID-19 hospitalization trends by race and ethnicity, 2020-2023. 

. 2025;8(7):e2521009. doi:10.1001/jamanetworkopen.2025.21009

2. AAP analyzes pediatric COVID-19 hospitalizations from 2020-’24. 

https://publications.aap.org/aapnews/news/29182/AAP-analyzes-pediatric-COVID-19-hospitalizations

3. FDA approves first COVID-19 vaccine. News release. FDA. August 23, 2021. Accessed July 16, 2025. 

https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine

4. Morrow-Howell N. Why older people are among the first to get the vaccine. Washington University in St. Louis Institute for Public Health, Harvey A. Friedman Center for Aging. December 16, 2020. Accessed July 16, 2025. 

https://publichealth.wustl.edu/why-older-people-are-among-the-first-to-get-the-vaccine/

5. Kates J, Williams E, Rudowitz R. The last major phase of the COVID-19 vaccination roll-out: children under 5. 

. June 21, 2022. Accessed July 16, 2025. 

https://www.kff.org/coronavirus-covid-19/issue-brief/the-last-major-phase-of-the-covid-19-vaccination-roll-out-children-under-5/

Researchers characterized trends in COVID-19 hospitalizations by race and ethnicity among children from March 2020 to September 2023.

COVID-19 Hospitalizations Disproportionately Impacted Black, Hispanic Children

Susan Cornell, PharmD, CDCES, FAPhA, FADCES, discusses how pharmacists can help patients who express fear when starting insulin therapy. 

Pharmacists Can Enhance Patient Confidence During Insulin Initiation

Community pharmacists are vital in supporting patients who have been newly prescribed insulin. This moment can cause fear, confusion, and hesitation, making pharmacist-led education and encouragement essential to a successful start.

Hashim Zaibak, PharmD

Articles

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