Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity
Authors' conclusion
In this cohort study, most patients with overweight or obesity discontinued GLP-1 RA therapy within 1 year, but those without type 2 diabetes had higher discontinuation rates and lower reinitiation rates. Inequities in access and adherence to effective treatments have the potential to exacerbate disparities in obesity.
Study context
- Population
- US adults with overweight or obesity (BMI ≥27) newly initiating a dual-labeled GLP-1 RA (liraglutide, semaglutide or tirzepatide), 2018–2023, collective of US health care systems; mean age 54.4 years, 65.4% women
- Participants
- 125,474 adults
- Exposure
- Patients without T2D vs with T2D
- With T2Dn = 76,524reference
- Outcome
- Proportions discontinuing and reinitiating GLP-1 RA (Kaplan-Meier)
- Follow-up
- Up to 2 years for discontinuation; 2 additional years for reinitiation
Methodological detailselectronic health record data, stratified by T2D at baseline
- Electronic health record data
- Stratified by T2D at baseline
Main finding
As reported in the abstract
Discontinuation · 1 year
Observational data: associations, not effects.
Further findings
| Outcome | Without T2D | With T2D |
|---|---|---|
| Reinitiation (among 41 792 who discontinued with discontinuation weight available) · 1 year | 36.3% (CI 35.6%–37.0%) | 47.3% (CI 46.6%–48.0%) |
Weight loss and discontinuation
- Lower hazard of discontinuation per 1% weight reduction, with T2D
- 3.1% (95% CI, 2.9%-3.2%)
- Lower hazard of discontinuation per 1% weight reduction, without T2D
- 3.3% (95% CI, 3.2%-3.5%)
Income >$80 000 and discontinuation (T2D only)
- HR
- 0.72 (95% CI, 0.69-0.76)
Weight regain and reinitiation
- Increased hazard of reinitiation per 1% weight regain, with T2D
- 2.3% (95% CI, 1.9%-2.8%)
- Increased hazard of reinitiation per 1% weight regain, without T2D
- 2.8% (95% CI, 2.4%-3.2%)
Safety
Moderate or severe incident GI adverse events and discontinuation
- HR, with T2D
- 1.38 (95% CI, 1.31-1.45)
- HR, without T2D
- 1.19 (95% CI, 1.12-1.27)
Original publication
Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity. JAMA Netw Open. Published 2 January 2025. doi:10.
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