A group of medications known as glucagon-like peptide 1 (GLP-1) receptor agonists are used to lower blood sugar in patients with type 2 diabetes mellitus; a disease that causes abnormally high blood sugar levels. They can also be prescribed as weight-reducing medications for overweight or obese patients who are not able to lose weight with diet and exercise. Studies have shown that GLP-1 receptor agonists have other health benefits such as reducing the chance of death from heart disease and slowing the worsening of kidney disease. In England, these drugs can be prescribed by general practitioners. Given the health benefits of GLP-1 receptor agonists, we aim to explore the uptake of the prescribing of these medications in primary care. To do this, we aim to assess the prescribing rates of GLP receptor agonists using the Clinical Practice Research Datalink data. We will describe prescribing patterns, taking into account patient characteristics such as gender, age groups, socioeconomic status and those with diabetes or obesity. The findings of this study will show the prescribing rates of GLP-1 receptor agonists by general practitioners in England, and whether prescribing rates are higher or lower in patients with different characteristics. These findings can be used to track changes in the use of GLP1 receptor agonists over time.
Type 2 diabetes mellitus (T2DM) is the most common endocrine disease and is associated with a high disease burden. Poorly controlled T2DM leads to short and long-term complications and is a major contributor to cardiovascular disease and chronic kidney disease. Metformin is considered the first line anti-diabetic agent given its weight neutral effect and its efficacy in lowering glycated haemoglobin (HbA1c). Glucagon-like peptide 1 (GLP-1) receptor agonists are generally recommended as second-line or third-line anti-diabetic agents when response to a combination of oral antidiabetic agents is inadequate. They are especially preferred when weight loss is desired and in patients who would benefit from cardiovascular risk reduction. Due to their efficacy in weight reduction, GLP-1 receptor agonists are approved as pharmacologic intervention in obese patients or those who are overweight with obesity-related complications. Moreover, semaglutide has been recently shown to reduce cardiovascular mortality in obese patients without diabetes. Given the favourable risk-benefit profile of GLP-1 RA and its potential as a first-line drug prescribed by GPs to treat obesity, there is a need to describe real-world GLP-1 receptor agonists utilization in England. This information would provide insight on the current rate of GLP1-RA prescribing in primary care practices, which can support and provide evidence to inform policy makers.
We aim to describe the prescribing patterns of GLP-1 receptor agonists in England between January 2007 to the last available data in 2024. We will describe drug utilization and patient characteristics of GLP-1 receptor agonists using Clinical Practice Research Datalink (CPRD) Aurum. We will first describe the annual incidence rate of GLP-1 receptor agonists prescribing between 2007 and 2024; stratified by age groups, gender and type of GLP-1 receptor agonist. We will then describe the characteristics of patients with T2DM or who are overweight or obese stratified by comorbidities.
This is a descriptive study and the primary outcome is prescribing patterns of GLP-1 receptor agonists in England.
Ruth Brauer - Chief Investigator - University College London ( UCL )
Shaikha Alnaimi - Corresponding Applicant - University College London ( UCL )
Kenneth Man - Collaborator - University College London ( UCL )
Li Wei - Collaborator - University College London ( UCL )
Patient Level Index of Multiple Deprivation;CPRD Aurum Ethnicity Record