Introduction & Objective: Clinical trials in adults with type 2 diabetes (T2D) have shown remarkable reductions in A1c and body weight for tirzepatide, the first dual GIP/GLP-1 receptor agonist approved in the US for T2D. The utilization trends and uptake of tirzepatide in adults with T2D in the US remain unexplored.

Methods: Using a US commercial claims database, we identified adults ≥18 years with T2D who initiated glucose-lowering drugs between 1/2021 and 6/2023 and plotted monthly drug initiation trends before and after the approval of tirzepatide for T2D (5/2022). We also compared the uptake of tirzepatide to the historical uptake of other GLP-1 receptor agonists (GLP-1RA) during the first 13 months since their initial approval for T2D.

Results: Between 1/2021 and 6/2023, metformin use decreased (from 25.5% to 20.7% of all glucose-lowering drug initiators), whereas GLP-1RA and SGLT2i use increased (from 17.6% to 23.0% and from 15.6% to 20.0%) (Fig. Panel A). The use of tirzepatide increased steeply after 10/2022, reaching 11.5% in 6/2023. By 6/2023, GLP-1RA were the most frequently initiated glucose-lowering drugs. During the first 13 months after approval, tirzepatide uptake was much steeper than any other GLP-1RA (Fig. Panel B).

Conclusion: Tirzepatide and other GLP-1RA are now the most frequently initiated glucose-lowering drugs for T2D. The uptake of tirzepatide is unprecedented with respect to any other GLP-1RA.

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Disclosure

E. Patorno: Research Support; Boehringer-Ingelheim, Food and Drug Administration (FDA), National Institutes of Health, Patient-Centered Outcomes Research Institute. H. Tesfaye: None. J. Ortega-Montiel: None. C. Alix: None. E.C. DiCesare: None. S. Cromer: Other Relationship; Johnson & Johnson Medical Devices Companies. Advisory Panel; Alexion Pharmaceuticals, Inc. Other Relationship; Wolters Kluwer Health. D.J. Wexler: Other Relationship; Novo Nordisk. J.M. Paik: None.

Funding

Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School

© 2024 by the American Diabetes Association
2024
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