Objective: Tirzepatide is a once weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist approved for treatment of type 2 diabetes (T2D) and obesity. This study aimed to understand characteristics and dosing patterns of tirzepatide in adults without T2D in a real-world setting.

Methods: This retrospective, descriptive, cohort study utilized the Veradigm EHR database linked with claims. The first tirzepatide prescription (National Drug Code for Mounjaro®) between May 13, 2022 and Aug 31, 2023 was the index date. Tirzepatide was only approved for the treatment of T2D during the index period, therefore any use of tirzepatide by individuals without T2D during this time was off-label and solely at the discretion of their prescribing physician. Patient characteristics and 6-month (mo) follow-up dosing patterns were assessed among anti-obesity medication eligible [BMI ≥ 30 kg/m2 or BMI ≥ 27 kg/m2 with ≥1 weight-related comorbidity] adults with no history of T2D diagnosis or medications (except metformin); all were required to have 12-mo pre- and 6-mo post-index claims enrollment.

Results: 3,470 adults without T2D diagnosis or medications (except metformin) initiated tirzepatide. The majority were female (76%), Caucasian (50%), mean age 45 yrs, mean BMI 35.8 kg/m2 (n=1955), and mean weight 231.8 pounds (n=1985). 77% of adults had ≥1 obesity-related comorbidity with hypertension (41%), dyslipidemia (40%), and prediabetes (29%) being the most common. At initiation (n=3,470), 74% received 2.5mg, 18% 5mg, 4% 7.5mg, and 2% 10mg. At 5th prescription fill (n=849), 17% were receiving 2.5mg, 36% 5mg, 25% 7.5mg, 14% 10mg, 6% 12.5mg, and 2% 15mg.

Conclusion: Real-world evidence suggests by the 5th prescription fill, the majority of adults receiving tirzepatide without T2D were receiving doses less than 10mg and may not be titrating up to maximum tolerated doses (10mg or 15mg) from the clinical trial program.

Disclosure

T. Gibble: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. C. Chinthammit: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. J. Ward: Employee; Eli Lilly and Company. K. Cappell: Employee; Veradigm, Chicago, IL, USA. R. Sedgley: None. M. Bonafede: Employee; Veradigm. Other Relationship; Moderna, Inc. B. Liao: Employee; Eli Lilly and Company. E.R. Hankosky: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company.

© 2024 by the American Diabetes Association
2024
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