644-P: Racial Ethnic Disparities in Prescription of GLP-1 Receptor Agonists for People at High Risk for Diabetes on Atypical Antipsychotics

Introduction: Atypical antipsychotics (AAP) significantly increase the risk of obesity and type 2 diabetes (T2D). GLP-1 receptor agonists (GLP-1 RA) are weight-loss medications which may be beneficial in treating AAP-induced weight gain. We evaluated trends in prescriptions of GLP-1 RA among patients at high risk of T2D using AAP stratified by race-ethnicity. Methods: We modeled covariate-adjusted trends in GLP-1 RA (liraglutide, semaglutide) prescriptions between January 2019-November 2023 from the Epic Cosmos dataset among a real-world cohort at high risk of T2D on AAP. We included 121,493 adults (18-99 years) with obesity or overweight (BMI ≥ 27kg/m2) and weight-related comorbidity (hypertension or hypercholesterolemia). We report trends in GLP-1 RA prescriptions by race-ethnicity (Hispanic, Non-Hispanic NH White, NH Black, NH Other). Results: The analytic sample was 59.0% female, 72.2% NH White, 16.2% NH Black, and 5.8% Hispanic with mean age of 51.4 (SD: 19.2) years. There were no differences by race-ethnicity in 2019. However, in 2023 relative to NH White patients (2.2% 95% CI: 1.4, 3.1), prescriptions were lower for NH Black (-1.1% -2.8, 0.1), Hispanic (-1.5% -2.7, 0.0) and NH Other (-1.2% -2.7, 0.0), Figure. Conclusion: There are emerging racial-ethnic disparities and underuse of effective weight loss medications among patients treated with AAP. Disclosure J. Varghese: None. D. Goldsmith: None. R. Waford: None. R. Chakkalakal: None. M.K. Ali: Advisory Panel; Eli Lilly and Company. F.J. Pasquel: Research Support; Tandem Diabetes Care, Inc., Insulet Corporation, Dexcom, Inc., Ideal Medical Technologies, Novo Nordisk. Consultant; Dexcom, Inc., Medscape. R.O. Cotes: Research Support; Roche Pharmaceuticals, Alkermes, Otsuka America Pharmaceutical, Inc., Karuna Therapeutics. Consultant; Saladax Biomedical. Speaker's Bureau; Saldax Biomedical, Clinical Care Options (CME company).