Characterisation of real-world patients who discontinued a glucagon-like peptide-1 agonist

Abstract

Aims: The objective of this analysis was to identify the 6-month discontinuation rate for GLP-1 analogues, reasons for discontinuation, and characteristics associated with discontinuation. Materials and methods: This was a retrospective analysis of adult patients who had an initial GLP-1 (semaglutide or liraglutide) dispensed between January 1, 2018 and June 30, 2023. The primary outcome was the 180-day GLP-1 discontinuation rate, and among those who discontinued, identification of documented reasons for discontinuation. The secondary outcome was the identification of patient characteristics associated with GLP-1 discontinuation. Results: There were 1374 patients included, of whom 436 (31.7%) discontinued GLP-1 therapy. Common reasons for GLP-1 discontinuation included: 26.8% with an adverse drug reaction (ADR), 14.4% with a GLP-1 cost concern, and 11.2% with non-adherence. Asian/Native American/Pacific Islander races (adjusted odds ratio [AOR] 2.51; 95% confidence interval [CI] 1.07–5.91 compared to Whites) and an overweight/obesity indication (AOR 2.46; 95% CI 1.17–5.17 compared to diabetes + overweight/obesity) were associated with GLP-1 discontinuation. Conclusions: 180-day GLP-1 discontinuation was prevalent. ADR and cost concerns were primary reasons for discontinuation and health disparities among patients who discontinued were identified. These real-world findings offer patients, providers, and policymakers evidence of potential barriers to GLP-1 persistence.