Allergy

Autoimmune Diseases

Biosimilars

COVID-19

Cannabidiol (CBD)

Cardiology

Compounding

Continuous Glucose Monitoring

Dermatology

Diabetes

Digestive Health

Endocrinology

Eye Health

Generics

Headache and Migraine

Immunization

Infectious Disease

Influenza

Insulin Management

Medical Devices

Mental and Behavioral Health

Neurology

Obesity Management

Oncology

Nonopioid Pain Management

Pain Management

Pediatrics

Pneumococcal

Public Health

Rare Diseases

Respiratory

Rheumatology

Shingles

Substance Use Disorder

Technology and Data

Veterinary Pharmacy 

Women's Health

News

FDA Updates

Law and Advocacy

Technology Trends

Viewpoints

All News

Media

In-Depth Insights

Pharmacist View

Script-Ed

Expert Interviews

Podcasts

Conferences

Conference Coverage

Conference Listing

Resources

Disease Awareness 

White Board Video

American Pharmacists Month

CME/CE

Partners

Publications

Drug Topics Journal

Total Pharmacy Journal

Submission of Articles

Events

Virtual Events

Total Pharmacy Solutions Summit

Business

Business Strategies

Patient Services

Pharmacy Inventory

Law and Regulations

All Business News

Practice Type

Independent Pharmacy

Chain Pharmacy

Specialty Pharmacy

Health System Pharmacy

Pharmacy Technicians

Subscribe

Videos

Joey Mattingly, PharmD, MBA, PhD, and Marta Wosinska, PhD, discussed what pharmacy businesses can do to prepare for the potential implementation of tariffs on pharmaceutical products. 

Pharmacists Must Advocate, Prepare for Potential Tariffs on Pharmaceuticals

Articles

Although there is no cure for MS, treatment focuses on recovery from attacks, reducing relapse, slowing disease progression, and managing multiple sclerosis symptoms.

Fenebrutinib Maintains Low Levels of Multiple Sclerosis Activity for 96 Weeks

In a session at PQA 2025, presenters discussed the impact of SDoH on health outcomes and how pharmacy teams can identify and address barriers.

Pharmacists Play Key Role in Addressing Social Determinants of Health | PQA 2025

Drug Topics was joined by Marta Wosinska, PhD, and Joey Mattingly, PharmD, MBA, PhD, to discuss the potential impact tariffs may have if they are widely implemented within the pharmaceutical industry.

How Pharmaceutical Tariffs May Burden Pharmacy Businesses

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

About

Advertise

Editorial

Editorial Board

Contact Us

Terms and Conditions

Privacy

Do Not Sell My Personal Information

Drug Topics – Pharmacy News and Multisetting Practice Insights

Facebook

LinkedIn

Spotlight

APhA Annual Meeting

AAP Annual Meeting

NCPDP Annual Conference

1rem

Authors

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

Don’t get left behind: Sign up today for our 

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

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

The FDA granted interchangeability designation to adalimumab-bwwd (Hadlima) as both high and low concentrations of adalimumab (Humira). The biosimilar is also approved as autoinjectors and a high-concentration prefilled syringe. This designation followed Hadlima low-concentration prefilled syringes and single-dose vials, which were designated in June 2024.

“An increased uptake of biosimilars may lead to improved patient access to biologic therapies and potential savings for the US health care system. As a company dedicated to making medicines more accessible, Hadlima, now designated as fully interchangeable with the reference product, has a greater potential to bring savings for patients. As our data shows, on average, patients paid more than four times as much out of pocket per month for Humira compared to Hadlima,” Jon Martin, commercial lead of biosimilars and established brands at Organon, said in a news release.

 “With this approval, pharmacies can substitute Hadlima for the reference product Humira without consulting prescribers (subject to state law), which may facilitate increased access for patients to receive the medications they need.”

The biosimilar is approved for rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurativa, and uveitis. The designation was based on clinical data from a randomized, double-blind 1:1 ratio clinical trial that assessed the pharmacokinetics, efficacy, safety, and immunogenicity for both treatment groups, including patients with plaque psoriasis between formulations of EU-sourced Humira and the high-concentration biosimilar compared with patients receiving Humira.

Investigators found that the primary pharmacokinetic end points between both groups were comparable. Further, the efficacy, safety, and immunogenicity profiles were also similar for the switching and continuous treatment groups, according to the findings from the study.

“This designation is meaningful as it signifies our continued commitment to making biosimilars more accessible. Both biosimilars and interchangeable biosimilars are highly similar and have no clinically meaningful differences in safety, purity, and potency compared to the reference product,” Byoung In Jung, vice president and regulatory affairs team leader at Samsung Bioepis, said in the news release.

 “With this designation, we continue to benefit patients, health care providers, and health care systems around the world.”

The biosimilar was first available in July 2023, and the citrate-free, high-concentration was approved at the same time. In May 2025, the FDA also granted expanded interchangeability designation for adalimumab-aaty (Yuflyma) for prefilled syringes and autoinjectors for Humira. It is also a high-concentration, citrate-free biosimilar marketed across all dosage forms and strengths.

Adalimumab-aaty was initially designated interchangeability status in early April 2024 and was approved in May 2023. The biosimilar is also approved for the same indications as the reference product.

"This full interchangeability designation comes at a pivotal time as Celltrion continues to lead in the evolving biosimilar landscape," Thomas Nusbickel, chief commercial officer at Celltrion USA, said in a news release.

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

1. US Food and Drug Administration (FDA) Grants Interchangeability Designation to Samsung Bioepis and Organon Hadlima (adalimumab-bwwd) Injection. News release. Organon. May 27, 2025. Accessed May 27, 2025. https://www.organon.com/news/us-food-and-drug-administration-fda-grants-interchangeability-designation-to-samsung-bioepis-and-organon-hadlima-adalimumab-bwwd-injection/

2. Biscaldi L. Five Adalimumab Biosimilars Now Available in US Market. 

. July 5, 2023. Accessed May 27, 2025. https://www.drugtopics.com/view/five-adalimumab-biosimilars-now-available-in-us-market

3. Samsung Bioepis and Organon Announce FDA Approval of Citrate-Free High-Concentration Humira Biosimilar Hadlima (adalimumab-bwwd). News release. Organon. August 17, 2022. Accessed May 27, 2025. https://www.organon.com/news/samsung-bioepis-and-organon-announce-fda-approval-of-citrate-free-high-concentration-humira-biosimilar-hadlima-adalimumab-bwwd/

4. Gallagher A. FDA Grants Expanded Interchangeability Designation to Yuflyma. 

. May 23, 2025. Accessed May 27, 2025. https://www.drugtopics.com/view/fda-grants-expanded-interchangeability-designation-to-yuflyma

This designation follows Hadlima’s low-concentration prefilled syringes and single-dose vials, which were designated in June 2024.

FDA Grants Interchangeability Designation to Adalimumab-Bwwd for Humira

When it comes to the current trends regarding hepatitis A and B vaccines, coverage is much more notable among children than it is compared with adults. However, both populations would significantly benefit from increases in hepatitis vaccine uptake, encouraging pharmacists to consider alternate methods of facilitating this increase in immunizations.

“There's just a general mistrust in vaccines. Again, that misinformation versus disinformation is important,” said Jeff Goad, PharmD, MPH, president of the National Foundation for Infectious Diseases. “Thinking about, how do we normalize some of this? Well, you have to talk to your patients. So, that's offering vaccines, for example, at every pharmacy visit, reducing some of those access barriers, since we know that most of the population walks through the doors of a pharmacy every week.”

Goad joined us on this week’s episode of Over the Counter to discuss general topics surrounding hepatitis. Getting the chance to meet with him during Viral Hepatitis Awareness Month, Goad provided some key insights into the basic understanding of hepatitis A, B, C, D, and E, as well as what vaccines are available to protect against these diseases.

He then explored common myths that are surrounding these FDA-approved vaccines and provided some easy ways for pharmacists to maneuver these myths and combat patients’ vaccine hesitancy. Listen here to the full conversation, or check it out on Spotify and any other podcast-streaming channel.

Stay tuned for weekly podcast episodes on 

 every Thursday afternoon. Check out our previous episode with 

, former chief medical officer at Amazon Pharmacy and NBC News medical analyst. At the 

National Council for Prescription Drug Programs 2025 Annual Conference

, Gupta joined Over the Counter to discuss his ideas on what the future of pharmacy may bring.

Are you ready to elevate your pharmacy practice? Sign up today for our 

During Viral Hepatitis Awareness Month, Jeff Goad, PharmD, MPH, joined Over the Counter to discuss hepatitis vaccines and the common trends pharmacists in this space should keep in mind.

The Common Trends in Hepatitis Vaccine Uptake, Hesitancy

Luke Turnock, PhD, MSc, has done extensive research on prescription drug markets and how these products have been promoted on social media in recent history. He’s specifically versed in the promotion of weight-loss medications, testosterone replacement therapy (TRT), and sexual enhancement products. Throughout his research, he and his colleagues have uncovered an alarming normalization of these products that can potentially lead to poor outcomes for many consumers globally.

We had a chance to catch up with Turnock, who began his discussion touching on glucagon-like peptide-1 (GLP-1) drugs for weight loss.

“The [weight-loss drugs] people are buying [are] semaglutide, which is Ozempic and Wegovy; tirzepatide, which is Mounjaro; and liraglutide, which is Saxenda,” said Turnock. “Those tend to be the ones that are getting promoted and those have been approved as prescription-only medicines that you can access through your doctor if you need them for weight-loss purposes. It's designed for those who need that type of drug to control that weight. What we've seen since about 2021-2022 is just an explosion of interest from people who don't fit within those categories."

In part 1 of our interview with Turnock, he dove deep into insights he and his colleagues provided in their article titled “Semaglutide, testosterone, and sildenafil advertising on social media: the normalization of lifestyle enhancement drugs.” He discussed the normalization of GLP-1s, TRT, and sexual enhancement drugs like sildenafil and tadalafil.

Semaglutide, TRT Advertising Contributing to Normalization of Use

: With your expertise in enhancement drugs, as well as your work on published articles like “Semaglutide, testosterone, and sildenafil advertising on social media: the normalization of lifestyle enhancement drugs,” what exactly is going on right now regarding these drugs and their circulation throughout social media?

Starting with the GLP-1 medicines, so semaglutide, tirzepatide. Those obviously started off as they were prescribed for treating diabetes, and there's been a recent shift, as we've understood, these are very good for weight loss. In the UK, a couple of them were approved for weight loss. There [are] others that aren't yet approved, like retatrutide, but the ones people are buying [are] semaglutide, which is Ozempic and Wegovy; tirzepatide, which is Mounjaro; and liraglutide, which is Saxenda. Those tend to be the ones that are getting promoted and those have been approved as prescription-only medicines that you can access through your doctor if you need them for weight-loss purposes. That's for people on prescription with a high BMI. I think it's 30 off the top of my head, but it's designed, obviously, for those who need that type of drug to control that weight.

What we've seen since about 2021-2022 is just an explosion of interest from people who don't fit within those categories. And of course, this is prior to them being approved for weight loss. Them being approved for weight loss came about a year after this explosion where there was a trend on a lot of social media sites, particularly TikTok, where people were coming to the realization these were really effective for weight management. A lot of the people who were promoting these were not people who would fall in that high level of BMI. They were people who just perceived themselves as slightly overweight or wanted to get in better shape for summer or whatever. There was just this explosion. You probably remember some of the articles around that time saying there's been shortage of diabetes medicines because so many people have started seeking them out because of social media.

That's kind of the background to this explosion. As this awareness of these drugs got everywhere, we then saw a rise in advertising. There are so many companies in that article, I listed a few of them. They are promising and they're putting out paid advertisements on places like YouTube and Facebook saying, ‘We sell this for X amount of money.’ Now, technically a prescription medicine in the UK, you can't say ‘You can buy this from us for this amount.’ That's not how prescription works, but these companies are doing it. And then for the influencer culture, there's a lot of beauty pages, fitness pages, this sort of thing. They often are sponsored by more of illicit company to sell. These peptide sellers and so on will have influencers who they give free product to and they perhaps have a referral link; you click their link and they get a kickback. Those are essentially selling potentially quite sketchy products when you buy from them because they're often not actual prescription medicines. Even if they appear to be, they're very likely produced in China in powder form, not necessarily the highest quality. Ashraf and colleagues did some research on this, checking, ordering semaglutide over the internet, and they found quite a big degree of variation in what's underdosed, what's overdosed. Some of it was as much as 39% overdosed, which, of course, presents a risk. And that's being shipped to, for instance, the UK, where it's often then being drawn up into insulin syringes, after being reconstituted and just sent out in an insulin syringe with perhaps handwritten instructions on this is the doses you should be using, which, of course, has a lot of potential for harm.

There are quite a few difficulties with just the prevalence of this. And also, do consumers necessarily know what is legitimate pharmaceutical product versus, ‘Oh, this is sold by this beauty page’ and they have no idea that actually that [may] not [be] safe to use. Even if it is, does the dosing information being given by that seller even reflect what the clinical dosing protocols should be, because you're meant to titrate up GLP-1 medicines. Whether users know that, we've certainly got examples. The 

 have reports on some examples where people have been hospitalized, have been put into hyperglycemic comas from using these drugs. So that's kind of the background to the GLP medicines.

In terms of testosterone. Again, it's kind of two-fold in that you have this illicit market and you have the TRT market. You've long had bodybuilders and so on use testosterone and use steroids. With the rise in gym and fitness accounts and fitness influencers, quite a few of these are either directly selling or they're showing links to people who are selling illicit testosterone, being a scheduled drug, a Class C drug in Britain, obviously higher classification in the US. Those are premised around getting big, getting ripped, getting shredded, and it's mostly these male fitness influencers. What we're also seeing is the rise of these TRT services, where some of that is by fitness-type influencers, but some of it is more general advertising that's going out everywhere, on Instagram, TikTok, Facebook, YouTube, even. That's for the ‘check your testosterone levels,’ ‘buy our home testing kit.’ They'll generally list a range of symptoms and things that they say could be associated with low testosterone to encourage people to try their testing kits and then hopefully be paying them for prescription tests.

So obviously, TRT, testosterone replacement therapy, that traditionally has been for older men, when your natural testosterone levels start to decline. Potentially, as they say about the male menopause, it can be used as a treatment for that. It might also be used for men with hypogonadism or specific medical conditions. But with these recent trends in advertising, a lot of them seem to be targeting a younger demographic. If you look at some of the men in the adverts, they'll be using guys in their late ‘20s, for instance—not traditionally a market who particularly needs TRT. They should—unless they have a specific medical condition, or maybe if they messed around with a lot of steroids when younger and tank their testosterone levels—they shouldn't really be the market for this. But some of the language that's used to promote it, there's some posts about ‘Testosterone levels are declining worldwide, your grandfather [had] much higher testosterone levels than you do, get your levels checked.’ Some of it's to do with if you're feeling down, if you're feeling fatigued, if you struggle to concentrate, you probably have low testosterone. And some of it is also based around libido and sexual performance, which I'll probably come to in a second because that ties in with the third example I want to use of the sexual enhancers.

All these claims very much frame it around if you have this condition or you have this concern, or potentially even in that kind of broader masculinity, testosterone levels are declining population wide. It's all very much targeted to your problems now are the result of low testosterone, so you need to get on this. As I said, the men they're primarily marketing to are not the men who most need TRT. So with the low-libido adverts, there's one example we used in the article that said, ‘Sex isn't everything, said the man with low testosterone.’ It's playing on this idea that you need testosterone for sexual performance, and if you don't have peak sexual performance, it's probably because you have low testosterone and you should buy our kits, get tested, get a prescription.

Now, Andrew Richardson's done some interesting work around this area. Essentially, what's happening, very much as with the gym and fitness culture, everything's moving towards this enhanced idea of these guys on steroids are setting the norm for sex. It seems to be that the porn consumption is so prevalent that a lot of guys are looking at that thinking that's what sex is supposed to look like. ‘If I don't have porn star performance, that means there's something wrong with me.’ And so, companies advertising testosterone prey on that, but so potentially do the ones that are selling these sexual enhancers.

Drugs like tadalafil (Cialis), sildenafil (Viagra), those are being promoted again to young men, not the population who medically tends to need them. It's generally older men who suffer from clinical erectile dysfunction, but they're being promoted as these more recreational drugs. Blue Chew was like the big one that I remember several years ago, back in 2018, and various podcasts have promoted it. You've got a bunch of guys in their late ‘20s, early ‘30s, saying about, ‘Oh, Blue Chew is so good. It helps with your sexual performance.’ A range of influencers [are] promoting it, and obviously, mainly targeting men in their ‘20s. Now, again, with advertisements, the problem is, if you're promoting these drugs to people who wouldn't necessarily clinically need them, but you're leading them to believe you need them because you don't have this porn star sexual performance, the problem is, you can create psychological dependency from using these drugs. That’s being sold as this recreational thing, and just have more fun sex, and your sex will be better using this. Obviously, that can then lead to actual erectile dysfunction occurring once they become dependent psychologically on them.

The Rise in Direct-to-Consumer Advertising of Prescription Drugs

Hirst M, Turnock LA. Semaglutide, testosterone and sildenafil advertising on social media: the normalisation of lifestyle enhancement drugs. 

https://doi.org/10.1016/j.peh.2024.100303

Luke Turnock, PhD, MSc, discussed current trends in the promotion of lifestyle enhancement drugs for populations they are not approved for.

Joey Mattingly, PharmD, MBA, PhD

Articles

Latest Updated Articles