Treatment discontinuation among users of GLP-1 receptor agonists and SGLT2 inhibitors in a national population of individuals with type 2 diabetes
Authors' conclusion
Approximately half of type 2 diabetes patients who had started using GLP-1 receptor agonists or SGLT2 inhibitors had discontinued treatment within 5 years of follow-up. However, more than half of those who discontinued treatment subsequently reinitiated treatment, such that the proportion with ongoing treatment was approximately 70-80% for both drugs during a 1-5 year period after treatment initiation. This suggests that the proportion of patients with long-term use of the medications is larger than indicated by analyses focusing on treatment discontinuation. Patient characteristics associated with treatment discontinuation were similar for GLP-1 receptor agonists and SGLT2 inhibitors.
Study context
- Population
- Patients with T2D in Sweden who filled a first prescription of a GLP-1 RA or SGLT2i between 2017 and 2021, nationwide registers
- Exposure
- New users of GLP-1 RA vs SGLT2i
- Outcome
- Cumulative incidence of treatment discontinuation (90-day grace period)
- Follow-up
- 1 and 3 years
Methodological detailsseparate analyses per drug class, Aalen-Johansen estimator, Fine-Gray sub-distribution hazard models, 90-day grace period
- Separate analyses per drug class
- Aalen-Johansen estimator
- Fine-Gray sub-distribution hazard models
- 90-day grace period
Main finding
As reported in the abstract
1 year
3 years
Observational data: associations, not effects.
Further findings
Cumulative incidence of reinitiation among those who discontinued · 1 year and 3 years after discontinuation
1 year
3 years
Switching within the same drug class
| Outcome | GLP-1 receptor agonists | SGLT2 inhibitors |
|---|---|---|
| Discontinuation at 3 years with grace period varied between 60 and 365 daysSensitivity analysis | 23.3% to 43.6% | 28.8% to 50.6% |
Proportion with ongoing treatment, regardless of previous discontinuation · 1-5 years after initiation
- Ongoing treatment for both drugs across grace periods
- ≈70% and 80%
Patient characteristics associated with discontinuation
- Similar for both classes; association of higher BMI with lower likelihood of discontinuation stronger for GLP-1 receptor agonists
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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