TOPLINE:

Since 2020, prescribing of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) for obesity without diabetes has risen, whereas their use for the treatment of type 2 diabetes (T2D) has declined.

METHODOLOGY:

• This population-based study used TriNetX, a real-time federated health research network with de-identified records of about 45 million people with at least one outpatient or inpatient visit in the United States during 2011-2023.

TAKEAWAY:

• There were a total of 871,854 new GLP-1 RA users during the study period.
• There was a decreasing trend in the proportion of new GLP-1 RA users with T2D, with a simultaneous twofold increase in the proportion of users without T2D but with a body mass index (BMI) of ≥ 30 kg/m² or of those with a BMI of 27-30 kg/m² and an obesity-related comorbid condition.
• The proportion of users without US Food and Drug Administration–approved indications increased from 0.21% in 2019 to 0.37% in 2023.
• In 2019, semaglutide and liraglutide accounted for 31.4% and 35.3% of all new GLP-1 RA prescriptions, respectively, rising to 88.1% for semaglutide, and decreasing to 10.3% for liraglutide in 2023.

IN PRACTICE:

“Given the high prevalence of obesity, the rising trend of new GLP-1 RA prescriptions for obesity may contribute to drug shortages. Further, drug shortages may exacerbate the existing nationwide racial and ethnic disparities in GLP-1 RA prescriptions,” the authors wrote. “Notably, the recent approval of tirzepatide for weight control in persons without diabetes and the FDA approval of the use of GLP-1 RAs to reduce cardiovascular disease risk will further broaden the indications of GLP-1 RAs and affect access…These findings call for strategies to address the growing demand and ensure equitable access to GLP-1 RAs.”

SOURCE:

The study was conducted by Yee Hui Yeo, MD, of the Cedars-Sinai Medical Center, Los Angeles, and colleagues. It was published online on July 23, 2024, in Annals of Internal Medicine.

LIMITATIONS:

The study was limited to TriNetX healthcare organization patient populations, which may not be nationally representative. Prescriptions of GLP-1 RAs for off-label indications such as steatotic liver disease or cardiorenal protection were not specified. Prescriptions from outside the participating healthcare organizations were not included. Those using GLP-1 RAs prior to enrolling in the participating plans were not included. Racial and socioeconomic factors were not examined.

DISCLOSURES:

The authors had no disclosures.