Introduction and Objective: Clinical trials show high rates of achieving weight-loss and HbA1c goals with glucagon-like peptide-1-based treatments (GLP-1s). Guidelines recognize ≥5% weight reduction as clinically meaningful, ≥10% weight reduction as providing greater metabolic benefit, and HbA1c 7% as a glycemic target. Low persistence may limit attainment of these goals. We evaluated how real-world GLP-1 discontinuation relates to achieving HbA1c and body-weight loss goals. Methods: We analyzed 18,187 patients with type 2 diabetes (T2D), body mass index (BMI) ≥25 kg/m2, and HbA1c ≥7% in the Market Clarity claims-EHR linked database who initiated a GLP-1 between January 1, 2021 and June 30, 2024. Adults with a BMI and HbA1c measured within 90 days before initiation and a follow-up measure 365 ± 90 days after initiation were included. Discontinuation was defined as a 60-day or longer gap without any GLP-1 supply. Multivariable regression adjusted for clinical and demographic factors estimated associations between GLP-1 discontinuation and achieving BMI and HbA1c goals over 1 year. Results: Over 1 year follow-up, 8,551 (47.0%) patients discontinued GLP-1 therapy. Among those who discontinued vs persisted, 33.0% vs 55.0% achieved ≥5% BMI reduction, 12.1% vs 26.9% achieved ≥10% BMI reduction, and 31.2% vs 60.9% achieved HbA1c 7%, respectively at one year. After multivariable adjustment, those who discontinued were 41% less likely to achieve ≥5% BMI reduction (risk ratio 0.59; 95% CI 0.57-0.62), 56% less likely to achieve ≥10% BMI reduction (risk ratio 0.44; 95% CI 0.41-0.47), and 47% less likely to achieve an HbA1c 7% (risk ratio 0.53; 95% CI 0.51-0.55). Conclusion: Half of patients with T2D discontinued GLP-1 treatment within 1 year, and discontinuation was associated with reduced likelihood of achieving guideline-recommended weight loss and HbA1c goals, representing a potential missed opportunity to realize full treatment benefits. Disclosure V. Fonseca: Consultant; Current; Abbott Diabetes. Stock/Shareholder; Current; BRAVO4HEALTH, LLC. Consultant; Ended; Bayer AG. Consultant; Current; Eli Lilly and Company, Corcept Therapeutics, Regeneron Pharmaceuticals Inc., Boehringer Ingelheim International GmbH. Stock/Shareholder; Current; Vertex Pharmaceuticals Incorporated. M. Girguis: Employee; Current; Amgen Inc. M. Donsmark: Employee; Current; Amgen Inc. Stock/Shareholder; Current; Novo Nordisk A/S. T. Sagendorf: None. B.C. Jaeger: None. P. Dluzniewski: Employee; Current; Amgen Inc. Stock/Shareholder; Current; Amgen Inc., UnitedHealth Group. Employee; Ended; UnitedHealth Group. P. Muntner: Research Support; Current; Amgen Inc. Consultant; Current; Novartis AG. Research Support; Current; Merck & Co., Inc.
FONSECA et al. (Fri,) studied this question.