Pharmacoepidemiology
Clinical comorbidities among users of glucagon-like peptide 1 (GLP-1) agonists without type II diabetes, a real-world data study Djeneba Audrey Djibo* Djeneba Audrey Djibo Jonathan DeShazo Smita Bhatia Cheryl N McMahill-Walraven
Background. Recently, glucagon-like peptide 1 (GLP-1) agonists originally developed for T2D management, were approved for obesity/weight loss applications among those without T2D. These novel applications of GLP-1 agonists could significantly change the clinical profiles of patients on these drugs.
Objective. We sought to examine the yearly prevalence of clinical conditions among persons using GLP-1 agonists without T2D.
Methods. We conducted a retrospective analysis of health insurance and pharmacy claims from 01 January 2019 to 31 October 2023 among eligible enrollees aged 12 years and above without T2D. Filled prescriptions of all GLP-1 agonists were identified using national drug codes (NDCs). Prevalent clinical conditions included HT, type 1 diabetes, stroke, CHD, gout, NAFLD, and all cancers and were identified using the International Classification of Disease (ICD-10-CM) diagnosis codes. Yearly prevalence per 1,000 enrollees were examined and compared a test for trend with statistical significance of p<0.05.
Results. For every 100,000 enrollees aged >12 years without T2D, 493 persons used GLP-1 agonists in 2019, 697 in 2020, 838 in 2021, 774 in 2022, and 973 persons in 2023, respectively. The proportion of GLP-1 agonists users with at least 1 comorbidity of interest increased per year (p<0.0001). Specifically, there were 13.0‰ users with prevalent hypertension in 2019 compared to 20.1‰ in 2023. Additionally, there were 0.4‰ users of GLP-1 agonists with prevalent stroke diagnoses in 2019 compared to 1.9‰ in 2023. Concerning obesity, 10.5‰ users of GLP-1 agonists were found in 2019 compared to 50.1‰ in 2023.
Conclusion. We observed increasing trends of GLP-1 agonists users with chronic clinical conditions as the uptake and applications are widening. Future directions may include investigations of pharmacovigilance using clinical and real-world evidence.