Persistence with once-weekly glucagon-like peptide 1 receptor agonist therapy decreases the risk of major adverse cardiovascular events: A retrospective analysis of patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease

AIMS: To assess the association between remaining persistent with once-weekly glucagon-like peptide-1 receptor agonists (OW GLP-1 RAs) and the risk of major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD). METHODS: We used the Optum Research Database to identify patients who initiated OW GLP-1 RAs between 1/1/2018-11/30/2022. Patients were classified as persistent or non-persistent depending on whether there was a ≥ 60-day gap in medication supply after they continuously used the medication for the first three months. Adjusted time-varying Cox proportional hazards models assessed the associations between persistence status and risks of 2-point MACE, stroke, and myocardial infarction (MI). RESULTS: Persistent (n = 18,849) and non-persistent (n = 10,667) patients were followed for an average of 418 and 741 days, respectively. Mean (SD) persistence was 418 (339), and 288 (234) days for persistent and non-persistent patients, respectively. Remaining persistent was associated with significantly lower risks of 2-point MACE, stroke, and MI (all p < 0.001). The corresponding HRs (95 %CI) were 0.696 (0.626-0.774), 0.668 (0.573-0.777), and 0.710 (0.621-0.813). CONCLUSIONS: Persistence with OW GLP-1 RA therapy was associated with significantly lower MACE risk among patients with T2DM and ASCVD in a real-world setting.