Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(1), P. e2457349 - e2457349

Published: Jan. 31, 2025

Importance Adherence to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is important for their effectiveness. Discontinuation and reinitiation patterns are not well understood. Objective To describe rates of factors associated with discontinuation subsequent GLP-1 RAs among adults overweight or obesity. Design, Setting, Participants In this retrospective cohort study, 125 474 obesity newly initiated treatment a dual-labeled RA (liraglutide, semaglutide, tirzepatide) between January 1, 2018, December 31, 2023, baseline body mass index 27 more, an available weight measurement within 60 days before initiation, regular care in the year initiation were identified using electronic health record data from collective US systems. Patients followed up 2 years assess additional reinitiation. Exposure stratified by presence type diabetes at baseline. Main Outcomes Measures Proportions patients discontinuing reinitiating estimated Kaplan-Meier models. Associations sociodemographic characteristics, factors, changes, gastrointestinal adverse events outcomes modeled time-varying Cox proportional hazards regression All analyses conducted separately without diabetes. Results study (mean [SD] age, 54.4 [13.1] years; 82 063 women [65.4%]), 76 524 (61.0%) had One-year was significantly higher (64.8% [95% CI, 64.4%-65.2%]) compared those (46.5% 46.2%-46.9%]). Higher loss (1% reduction 3.1% 2.9%-3.2%] lower hazard 3.3% 3.2%-3.5%] diabetes) income (type only; >$80 000: ratio [HR], 0.72 0.69-0.76]) discontinuation, while moderate severe incident (with diabetes: HR, 1.38 1.31-1.45]; 1.19 1.12-1.27]). Of 41 792 who discontinued available, 1-year (36.3% 35.6%-37.0%]) (47.3% 46.6%-48.0%]). Weight regain 1% increased 2.3% (95% 1.9%-2.8%) 2.8% 2.4%-3.2%) Conclusions Relevance most therapy 1 year, but rates. Inequities access adherence effective treatments have potential exacerbate disparities

Language: Английский

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A Revolution in the Treatment of Obesity

The American Journal of Medicine, Journal Year: 2024, Volume and Issue: 137(10), P. 925 - 928

Published: May 22, 2024

Language: Английский

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Prescription Fills for Semaglutide Products by Payment Method

JAMA Health Forum, Journal Year: 2024, Volume and Issue: 5(8), P. e242026 - e242026

Published: Aug. 2, 2024

This cross-sectional study examines trends in US prescription fills for semaglutide products by payment method between January 2021 and December 2023.

Language: Английский

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Comparing Clinical Practice Habits among Obesity Medicine Physicians by Patient, Physician and Clinic Factors

Obesity Pillars, Journal Year: 2025, Volume and Issue: 13, P. 100157 - 100157

Published: Jan. 7, 2025

While clinical practice habits vary by patient, physician and clinic factors in primary care, limited research has examined whether differences exist obesity medicine. Our objective was to compare such among medicine physicians certified the American Board of Obesity Medicine (ABOM). We conducted secondary analyses cross-sectional data from 2023 ABOM Practice Analysis Validation Survey. included three - prescribing anti-obesity medications (AOMs), off-label for weight reduction, hours (4-20 h/week versus >20 h/week). patient (patient population), (primary medical specialty, years experience) (practice setting, geographic catchment, accepts insurance care). bivariate using Χ2 tests. Among 565 ABOM-certified physicians, 71.5 % had specialties within care 9.2 predominantly treated children/adolescents with obesity. Overall, 97.5 prescribed AOMs 85.1 reduction. Fewer who compared no or treatment children (88.5 98.4 98.5 %, respectively; p < 0.001). 41.4 reported practicing h/week, which more likely occur as experience increased (i.e., 21.9 ​% 1-2 58.5 10+ years; ​< ​0.001). No significant occurred accepting insurance. findings may suggest that have consistent medication practices regardless factors, be particularly important patients seeking pharmacologic treatment. Most treat prescribe medications. These current rates are relatively higher than prior pediatric might help support access patients.

Language: Английский

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Building a Medical–Surgical Obesity Center: Updates and Quality Outcomes After Five Years

Bariatric Surgical Practice and Patient Care, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 20, 2025

Language: Английский

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Treating obesity in patients with depression: a narrative review and treatment recommendation

Postgraduate Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 19, 2025

The high morbidity of obesity and depression pose significant public health concerns, with the prevalence doubling in US between 1990 2022 patients frequently presenting both. Untreated can greatly impact patient well-being, as both are associated a number comorbidities including sleep apnea, type 2 diabetes mellitus, metabolic syndrome, dysfunction-associated steatotic liver disease, cardiovascular disease. This narrative review aims to provide comprehensive current overview overlapping etiologies well available treatment options that may be recommended by primary care professionals treat these concomitant depression. With considerable overlap population depression, neurobiological, hormonal, inflammatory pathways underlying diseases, should consider screening for Holistic options, lifestyle behavioral modifications, pharmacotherapy bariatric surgery critical manage conditions simultaneously. Therefore, due neurobiological mechanisms responsible incidence progression holistic plan strategies efficacy any additional improve clinical approach

Language: Английский

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Availability of Cardioprotective Medications for Type 2 Diabetes in the Medicaid Program

Annals of Internal Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: April 21, 2025

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are the only type 2 diabetes medications that reduce cardiovascular disease death, yet their availability in Medicaid is unclear. To assess unrestricted of SGLT2is GLP-1 RAs, using dipeptidyl peptidase-4 (DPP4is) as a benchmark. National cross-sectional study publicly available data. All 50 state fee-for-service (FFS) plans 273 nonelderly adult managed care organization (MCO) with comprehensive coverage March 2024. enrollees those Unrestricted was defined having at least 1 medication each class listed on preferred drug list without prior authorization or step therapy. Of FFS (including Washington, DC, excluding state, which had 5 MCO plans), 40 (80%) SGLT2is, 30 (60%) 41 (82%) either, 29 (58%) both, 42 (84%) DPP4is. Among (39 states; median, 6 [range, to 24 plans]), 182 (67%) 131 (48%) 184 129 (47%) 204 (75%) The proportion varied markedly among states (SGLT2i range, 24% 100%; RA 0% 99%; DPP4i 41% 100%). Primarily because more restrictions, 1.7 million (lower upper bound, 1.33 2.17 enrollees; 25%) restricted SGLT2i availability, 2.72 2.12 3.45 million; 40%) 1.5 1.17 1.90 22%) availability. Availability increased from 2020 2024, especially FFS, but has plateaued below 60% since 2022. Tirzepatide almost entirely restricted. Diabetes enrollment estimated plan size national prevalence appropriateness restrictions unknown. Many have access cardioprotective medications, particularly for substantial variation. Formulary potential lever increase these while balancing pharmaceutical costs. University California, San Francisco, Action Research Center Health Equity.

Language: Английский

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Discontinuation and Reinitiation of GLP-1 Receptor Agonists Among US Adults with Overweight or Obesity

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: July 29, 2024

Abstract Importance Adherence to GLP-1 RA is important for efficacy. Discontinuation and reinitiation patterns patients with without type 2 diabetes (T2D) are not well-understood. Objective To describe rates factors associated discontinuation of RA, T2D. Design In this retrospective cohort study, adults overweight or obesity initiated on between January 2018 December 2023 were identified using electronic health record (EHR) data from a collective 30 US healthcare systems. Patients followed up years assess additional reinitiation. Setting Clinical prescribing EHRs linked dispensing information Participants Adults newly 2023, baseline BMI ≥27 an available weight measurement within 60 days before initiation, regular care in the year initiation. Exposure/Covariates stratified by presence T2D at baseline. Associations socio-demographics, factors, changes, gastrointestinal (GI) adverse events (AE) modeled. Main Outcomes Measures Proportion discontinuing reinitiating estimated Kaplan-Meier models. covariates outcomes modeled time-varying Cox proportional hazards All analyses conducted Results Among 96,544 initiating mean (SD) age was 55.1 (13.3) years, 65.2% female, 73.7% white, 61.3% had Individual income exceeded $50,000 49.7% 57.2% One-year significantly higher (65.1%), compared those (45.8%). Higher loss, absence GI AE, (T2D only) discontinuation. Of 28,142 who discontinued available, one-year lower (34.7%), (51.0%). Weight re-gain increased Conclusions Relevance Most discontinue 1 year, but reinitiate rates. Inequities access adherence effective treatments have potential exacerbate disparities obesity. Key points Question How frequently do subsequently RA? What these outcomes? Findings study 46% 65% year. income, events, comorbidities Following discontinuation, 51% 35% reinitiated since Meaning While most tolerability, proxies sustained treatment.

Language: Английский

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Navigating coverage: A qualitative study exploring the perceived impact of an insurance company policy to discontinue coverage of antiobesity medication

Obesity Pillars, Journal Year: 2024, Volume and Issue: 11, P. 100120 - 100120

Published: July 22, 2024

Obesity rates continue to rise in the United States. Treatment includes modification of diet, exercise, behavioral and medical consideration including anti-obesity medications. However, multiple highly effective medications are expensive with that we see insurers opting out coverage these This has led patients having abruptly stop treatment The purpose this study is explore impact non-medical discontinuance obesity medication among weight management programs.

Language: Английский

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International coverage of GLP-1 receptor agonists: a review and ethical analysis of discordant approaches

The Lancet, Journal Year: 2024, Volume and Issue: 404(10455), P. 902 - 906

Published: Aug. 1, 2024

Language: Английский

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