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Fitusiran (Qfitlia) is approved for patients 12 years and older with or without factor VIII or IX inhibitors.

FDA Approves Fitusiran as Prophylaxis of Bleeding Episodes Due to Hemophilia A or B

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Independent Pharmacies Provide Personalized Care During COVID-19

Lauren Angelo, PharmD, associate dean for academic affairs at Rosalind Franklin University, explains common misconceptions and myths about vaccines.

Expert Discusses Vaccine Hesitancy, Vaccine Myths | APhA 2025

Currently, there is no vaccine to prevent chlamydia, but treatment includes regimens of antibiotics, including doxycycline, azithromycin, and levofloxacin.

FDA Grants Fast Track Designation to mRNA Vaccine Candidate for Chlamydia

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Susan Cornell, PharmD, CDCES, FAPhA, FADCES, associate director of experiential education at the College of Pharmacy at Midwestern University, also addresses personalized care and the expanding responsibilities of pharmacists.

Expert Discusses Critical Role of Technology in Diabetes Care | APhA 2025

Susan Cornell, PharmD, CDCES, FAPhA, FADCES, associate director of experiential education at the College of Pharmacy at Midwestern University, discusses recent advancements in diabetes care.


Expert Discusses Changes in Diabetes Care | APhA 2025

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

Click the link below to register for the Total Pharmacy® Solutions Summit September Summit:

https://registration.pharmacytimes.org/total-pharmacy-solutions-summit-patient-access-and-education

Total Pharmacy® Solutions Summit: September 13th 2025

Click the link below to register for the Total Pharmacy® Solutions Summit June Summit:

https://registration.pharmacytimes.org/total-pharmacy-solutions-summit-revenue-stream-diversification 

Total Pharmacy® Solutions Summit: June 14th 2025

Independent pharmacies are crucial to the communities they serve nationwide, according to a session presented at the American Pharmacists Association 2025 Annual Meeting and Exposition.

 With their unique positioning across the country, independent pharmacy closures are negatively affecting underserved communities and must be addressed for the benefit of public health in the US.

“What happens when pharmacies close? What are our patients losing? What are our communities losing?” asked Lucas Berenbrok, PharmD, MS, in a presentation titled Blank Space: Discussing Pharmacy Deserts. “Well, they're losing access to convenient care. They're also losing those touch points to discuss health. We know just how frequently or often patients are coming to see pharmacists in both Medicare populations and commercial payers; it's about twice as often as patients are seeing their primary care providers.”

In his presentation, Berenbrok provided the audience with an in-depth look at pharmacy closures, how they impact communities, and the dire need to address pharmacy deserts, which have spurred minimal access to care and medications in many urban and rural locales.

What is Being Done to Address Pharmacy Deserts in the US?

“You can put probably a list of 50-100 different reasons why we need good access to community pharmacies in the country,” he continued. “Usually, whenever I try to think about this myself, I think about the types of needs that I have, not as a pharmacist, but what I have as a patient, what I look to at my community pharmacy, what things I buy there, what things I expect my pharmacist to be able to help serve me.”

By putting himself in his patients’ shoes, and understanding how pharmacy access impacts them each individually, Berenbrok is able to easily shine a light on the importance of pharmacy services in various communities. And it’s not just the opinions and perspectives of pharmacists that prove how crucial pharmacies are to public health.

Journal of the American Pharmacists Association

 study found that community pharmacies are highly accessible health care destinations, specifically based on drive time, in both urban and suburban areas.

 Berenbrok also noted data explaining that 88.9% of the US lives within 5 miles of a community pharmacy while 91.1% live within 20 minutes of one.

“There's a lot of different ways in which we can define a pharmacy desert. It's based upon food desert definitions from the US Department of Agriculture and pharmacy deserts have been defined in 2 different ways in the literature,” said Berenbrok. Indeed, as previously mentioned, pharmacy deserts are either defined by drive time or distance. And with the term “pharmacy desert” only being coined in 2014,

 it may make sense why experts continue to deliberate on the definition of this lack in health care services.

While notably more challenging than calculating distance, drive time takes into account many more factors that translate to pharmacy access, including public transportation access, speed limits, traffic lights, time of day, and so much more. Berenbrok also touched on the fact that not all patients visit the pharmacy closest to their home and that pharmacy access to these people could be what’s closest to their work, children’s school, etc.

But despite continued debates on the best way to identify pharmacy deserts, the need to address them is significantly more important. “We have a problem with pharmacy closures for our country, but we also have a problem with pharmacy closures with specific populations, in which there already exists health disparities; we don't want those to widen,” he continued.

After defining the issue and highlighting the need to address pharmacy deserts, Berenbrok discussed the overarching policy reforms that may begin to alleviate these growing challenges within pharmacy. There are several ways for pharmacists to combat the loss of pharmacy services, including increased patient education, community outreach, patient surveys, and so much more. However, according to Berenbrok and several other experts within the industry, significant change that positively impacts the population may come from federal policy reforms.

Among many reforms that can have a beneficial impact on the pharmacy industry, Berenbrok focused on the need for increasing pharmacist reimbursement, further recognition of pharmacists as providers, and an increase in the services pharmacists are able to bill for.

Alleviating pharmacy deserts within the US will almost certainly be a gradual effort. But through education, advocacy, and community-based services, independent pharmacies have the ability to correct the path of public health in the US and offer valued care to all populations. These pharmacies, however, simply may not be able to do it alone.

As the issue of pharmacy closures and deserts is ongoing, Berenbrok concluded his presentation with a hopeful yet skeptical look to the future.

“So how do we make sure that we're protecting these pharmacies, that they're not closing, that they can continue to serve the people that they do?” he concluded.

 “Are there ways to increase reimbursement for those areas in need? Can there be government subsidiaries for pharmacies? These are all things that people are thinking about, writing about, and advocating for.”

Read more from our coverage of the American Pharmacists Association 2025 Annual Meeting and Exposition

1. Berenbrok L. Blank space: discussing pharmacy deserts. Presented at: American Pharmacists Association 2025 Annual Meeting and Exposition; March 21-24, 2024; Nashville, TN.

2. Sharareh N, Zheutlin AR, Qato DM. Access to community pharmacies based on drive time and by rurality across the contiguous United States. 

 (2003). 2024;64(2):476-482. doi:10.1016/j.japh.2024.01.004

3. Wittenauer R, Shah PD, Bacci JL. Locations and characteristics of pharmacy deserts in the United States: a geospatial study. 

. 2024 Mar 16;2(4):qxae035. doi: 10.1093/haschl/qxae035.

Lucas Berenbrok, PharmD, MS, discussed pharmacy deserts and how closures around the US have the potential to impact public health.

Independent Pharmacy Closures Significantly Impact Health of US Population | APhA 2025

As the most frontward facing providers within health care, pharmacists are constantly looking for more ways to expand their ability to treat patients and serve the greater community. With expertise in medication first, as well as a unique ability to manage patients and garner meaningful relationships that result in better health outcomes, pharmacists have served as a bridge between health care and the patients who receive it.

Pharmacists’ expertise in medication has given them the ability to manage various disease states, procuring medication management regimens that ensure successful health outcomes in patients with diseases like diabetes, cardiovascular disease, and so much more. But for individuals without comorbidities simply looking to improve their overall health and lifestyle, a certified nutritionist may be their best option for counsel.

However, pharmacists with a desire to become experts in nutrition—according to Sarah Gray, PharmD, GAICD, also known as 

—have the ability to stand out even more among other providers and be a crucial source of guidance for any patient looking to improve their lifestyle.

“The combination of pharmacy and nutrition is a match made in heaven. For me, pharmacists have such great skills across many areas,” she said. “I think the key [area] I've found that really matches well with nutrition is our great patient-interviewing skills and being able to really consider all factors of a patient's life; so what medications they're taking, what medical conditions [and] symptoms they have. Now, adding the nutrition side, I can get a really good picture of all the areas of the person's health.”

 to discuss her career journey, starting as a pharmacist and eventually pivoting to nutrition counseling and helping patients with their lifestyle journeys. She then explored overarching opportunities for pharmacists to expand their roles within health care. According to her, the opportunities are endless within pharmacy because of the profession’s wide range of continuously increasing knowledge.

“Don't be afraid to add things in that might seem a bit strange, but also, as a pharmacist itself, you don't need anything else, really. You can offer so much to people as a profession,” she said.

Known as “The Nutrition Pharmacist,” Sarah Gray, PharmD, GAICD, recently joined Drug Topics to discuss her dual profession within health care.

Susan Cornell, PharmD, CDCES, FAPhA, FADCES

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