Introduction and Objective: In clinical trials, glucagon-like peptide-1-based treatments (GLP-1s) improve glycemic control and promote weight loss in adults with type 2 diabetes (T2D), but the extent to which real-world persistence influences these outcomes remains unclear. Methods: This retrospective cohort study included 42,334 US adults with T2D who initiated semaglutide or tirzepatide between 2017-2023, with no prior use in the preceding year, in the Optum Market Clarity database. Patients with ≥1 HbA1c and/or weight measurement at initiation and at 6 and/or 12 months were included. Persistence was defined as continuous GLP-1 use without a ≥60-day refill gap. Patients were categorized as discontinuing within 0-3 months, 3-12 months, or persistent at 12 months. HbA1c and weight change were assessed at 6 and 12 months. Results: At 12 months, mean (SD) HbA1c change was -0.76% (1.81) among patients discontinuing within 0-3 months, -0.83% (1.76) among those discontinuing within 3-12 months, and -1.28% (1.6) among persistent patients. The proportion achieving ≥5% weight loss increased with persistence (27.8%, 35.6%, and 49.0%, respectively). Six and twelve-month outcomes are shown in the Table. Conclusion: Sustained GLP-1 use was associated with greater glycemic and weight benefits, but less than half of patients remained persistent at 12 months, underscoring the importance of long-term GLP-1 use in T2D and weight management. Disclosure J. Almandoz: Consultant; Current; AbbVie Inc., Amgen Inc., Boehringer Ingelheim International GmbH, Eli Lilly and Company, Kailera, Novo Nordisk, Metsera, Rhythm Pharmaceuticals, Inc., Rivus. M. Girguis: Employee; Current; Amgen Inc. M. Weintraub: None. M. Donsmark: Employee; Current; Amgen Inc. Stock/Shareholder; Current; Novo Nordisk A/S. P. Dluzniewski: Employee; Current; Amgen Inc. Stock/Shareholder; Current; Amgen Inc., UnitedHealth Group. Employee; Ended; UnitedHealth Group.
ALMANDOZ et al. (Fri,) studied this question.