OBJECTIVE Glucagon-like peptide 1 (GLP-1) receptor agonists (RAs), such as semaglutide, and dual GLP-1/glucose-dependent insulinotropic polypeptide RA, such as tirzepatide, are increasingly used for obesity management. However, real-world patterns of discontinuation, reinitiation, and switching among individuals without diabetes remain poorly described. This study describes the real-world patterns of discontinuation and reinitiation of subcutaneous semaglutide and tirzepatide in adults with obesity but without diabetes in an academic medical center. Secondary objectives included evaluating transitions between semaglutide and tirzepatide and switches from these agents to first-generation antiobesity medications (AOMs). RESEARCH DESIGN AND METHODS A retrospective cohort study of adults with obesity but without diabetes who were prescribed semaglutide or tirzepatide was conducted using electronic health record data. Patterns of discontinuation, reinitiation, and switching (change from one agent to another or to a first-generation AOM) were assessed over 12 months. RESULTS Among 9,189 adults initiating subcutaneous semaglutide or tirzepatide, 36.7% of the sample had a prescription that lasted 32 days (mean, 3.6 days), with 82.7% receiving no further prescriptions for AOMs that year. Prescription coverage was 32–179 days and 180–335 days in 27.0% and 17.7% of participants, respectively, with most (72.3% and 89.5%) not having any prescriptions for AOMs thereafter. Persistent prescriptions (coverage for ≥336 days) were observed in 18.6% of participants. Prescriptions to reinitiate or switch to another GLP-1 RA or first-generation AOM were rare. CONCLUSIONS In a real-world academic setting, a substantial proportion of individuals with obesity, but without diabetes, discontinued GLP-1–based treatments.
Ali et al. (Tue,) studied this question.