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. 2024 Oct;40(5):223-229.
doi: 10.1177/87551225241266773. Epub 2024 Jul 27.

Utilization of Glucagon-Like Peptide-1 Receptor Agonist and Dipeptidyl Peptidase-4 Inhibitors at the Veterans Health Administration

Aditya Krishnan  1 , Sowmya K Suryanarayanan  2 , Ishak A Mansi  3   4
Affiliations

Utilization of Glucagon-Like Peptide-1 Receptor Agonist and Dipeptidyl Peptidase-4 Inhibitors at the Veterans Health Administration

Aditya Krishnan et al. J Pharm Technol. 2024 Oct.

Abstract

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RA) and dipeptidyl peptidase-4 inhibitors (DPP-4i) are incretin-based therapies commonly used in the management of type 2 diabetes. Public interest in GLP-1RA soared after discovering their ability to lower body weight in patients without diabetes. Objective: To examine recent trends in usage of GLP-1RA and DPP-4i in the Veterans Health Administration (VHA). Methods: We extracted GLP-1RA and DPP-4i use from the national VHA Corporate Data Workhouse (CDW) between fiscal years (FYs) 2011 to 2021, which encompass medication class, name, dosage, date of filled prescription, and patients' characteristics. Results: A total of 3 037 006 prescriptions for DPP-4i and 2 183 294 prescriptions for GLP-1RA were filled during FY 2011 to 2021. More patients were prescribed DPP-4i (273 002 subjects) compared with GLP-1RA (157 209 subjects) from FY 2011 to 2021. Overall, 10.7% used DPP-4i for 90 days or less in comparison to 9.1% in GLP-1RA (P < 0.001). The proportion of patients prescribed DPP-4i who were 75 years of age or older was relatively stable over the years 2011 to 2021 (mean proportion = 19%). However, the proportion of patients who were 75 years of age or older prescribed GLP-1RA increased from 4.2% in 2011 to 16.9% in 2021. Conclusions: Incretin-based therapies have become a well-established class of drugs within the VHA. Even though DPP-4i usage in older adults has remained stable over the past 10 years, prescriptions for GLP-1RA in older adults have increased multifold over the last few years, which might be attributed to recent trial evidence showing benefit in cardiovascular outcomes and weight reduction.

Keywords: Veterans Health Administration; dipeptidyl peptidase-4 inhibitors; glucagon-like peptide-1 receptor agonist; type 2 diabetes.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Number of prescriptions filled for GLP-1RA and DPP-4i for VA patients from 2011 to 2021.
Figure 2.
Figure 2.
Number of patients initiated on GLP-1RA and DPP-4i prescriptions at the VA from 2011 to 2021.
Figure 3.
Figure 3.
Proportions of patients at the VA using GLP-1RA (panel a) or DPP-4i (panel b) for 90 days or more vs less than 90 days from 2011 to 2020.
Figure 4.
Figure 4.
Proportion of patients at the VA who were ≥75 years of age vs <75 years of age and who were prescribed GLP-1RA (panel a) or DPP-4i (panel b) during the years from 2011 to 2021.
See this image and copyright information in PMC

References

    1. Nauck M, Stöckmann F, Ebert R, Creutzfeldt W. Reduced incretin effect in type 2 (non-insulin-dependent) diabetes. Diabetologia. 1986;29(1):46-52. doi: 10.1007/BF02427280 - DOI - PubMed
    1. Nauck MA. Glucagon-like peptide 1 (GLP-1) in the treatment of diabetes. Horm Metab Res. 2004;36(11-12):852-858. doi: 10.1055/s-2004-826175 - DOI - PubMed
    1. Ahren B. DPP-4 inhibitors. Best Pract Res Clin Endocrinol Metab. 2007;21(4):517-533. doi: 10.1016/j.beem.2007.07.005 - DOI - PubMed
    1. Cahn A, Cernea S, Raz I. An update on DPP-4 inhibitors in the management of type 2 diabetes. Expert Opin Emerg Drugs. 2016;21(4):409-419. doi: 10.1080/14728214.2016.1257608 - DOI - PubMed
    1. Gilbert MP, Pratley RE. GLP-1 Analogs and DPP-4 inhibitors in type 2 diabetes therapy: review of head-to-head clinical trials. Front Endocrinol (Lausanne). 2020;11:178. doi: 10.3389/fendo.2020.00178 - DOI - PMC - PubMed

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