塞马鲁肽（Ozempic®）2018年至2023年在丹麦的使用情况--用户趋势和标签外减肥处方

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2024-04-01 DOI:10.2147/clep.s456170

Aurélie Mailhac, Lars Pedersen, Anton Pottegård, J. Søndergaard, Torben Æ. Mogensen, H. Sørensen, R. Thomsen

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引用次数: 0

摘要

目的：被批准用于治疗2型糖尿病（T2D）的塞马鲁肽注射液（Ozempic ®）的使用量激增导致了全球供应短缺。我们调查了丹麦当代使用塞马鲁肽（Ozempic ®）的比例和临床特征，以及 "标签外 "处方用于减肥的程度。患者和方法基于 2018 年 1 月至 2023 年 12 月的关联健康登记的全国性人群横断面研究。纳入了所有首次获得每周一次塞马鲁肽（Ozempic ® ）处方的成年人。我们以其他胰高血糖素样肽-1 受体激动剂和减肥药物作为对比，研究了每季度的新用户使用率和总用户使用率。我们还调查了使用者的特征，包括 T2D、血糖控制、合并用药和心肾疾病。结果在 2019 年至 2021 年期间，semaglutide (Ozempic ® ) 的新用户使用率保持稳定，约为每 1000 个成人年中有 4 人使用，然后加速增长，在 2023 年第一季度达到峰值，每 1000 人中有 10 人使用，之后急剧下降。2023 年，丹麦的用户普及率增至 91626 人。有T2D记录的semaglutide（Ozempic ® ）新用户比例从2018年的99%下降到2022年的仅67%，2023年再次上升到87%。在2023年开始使用semaglutide (Ozempic ® )的T2D患者中，52%在开始使用前接受了抗糖尿病多药治疗，39%接受了单药治疗，8%未接受抗糖尿病治疗。尽管使用了抗糖尿病药物，但大多数T2D患者的血糖控制不理想，83%的患者HbA1c≥48 mmol/mol，68%的患者HbA1c≥53 mmol/mol，29%的患者已患有动脉粥样硬化性心血管疾病或肾脏疾病。结论在丹麦，semaglutide（Ozempic ®）的使用量急剧增加。虽然未获批准用于无 T2D 的减肥，但 2022 年三分之一的新用户没有 T2D。相反，大多数患有 T2D 的启动者都有明确的加强治疗的医学指征，"标签外 "使用只能解释供应短缺的一小部分原因。

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Semaglutide (Ozempic®) Use in Denmark 2018 Through 2023 ‒ User Trends and off-Label Prescribing for Weight Loss

Purpose: A surge in the use of semaglutide injection (Ozempic ® ) approved to treat type 2 diabetes (T2D) has led to a global supply shortage. We investigated contemporary user rates and clinical characteristics of semaglutide (Ozempic ® ) users in Denmark, and the extent of “off-label” prescribing for weight loss. Patients and Methods: Nationwide population-based cross-sectional study based on linked health registries January 2018 through December 2023. All adults who received a first prescription of semaglutide once weekly (Ozempic ® ) were included. We examined quarterly rates of new users and total user prevalences, using other glucagon-like peptide-1 receptor agonists and weight loss medications as comparison. We also investigated user characteristics including T2D, glucose control, comedications, and cardiorenal disease. Results: The new user rate of semaglutide (Ozempic ® ) remained stable at approximately 4 per 1000 adult person-years between 2019 and 2021 and then accelerated, peaking at 10 per 1000 in the first quarter of 2023 after which it declined sharply. User prevalence increased to 91,626 users in Denmark in 2023. The proportion of semaglutide (Ozempic ® ) new users who had a record of T2D declined from 99% in 2018 to only 67% in 2022, increasing again to 87% in 2023. Among people with T2D who initiated semaglutide (Ozempic ® ) in 2023, 52% received antidiabetic polytherapy before initiation, 39% monotherapy, and 8% no antidiabetic therapy. Most T2D initiators had suboptimal glucose control, with 83% having an HbA1c ≥48 mmol/mol and 68% ≥53 mmol/mol despite use of antidiabetic medication, and 29% had established atherosclerotic cardiovascular disease or kidney disease. Conclusion: The use of semaglutide (Ozempic ® ) in Denmark has increased dramatically. Although not approved for weight loss without T2D, one-third of new users in 2022 did not have T2D. Conversely, most initiators with T2D had a clear medical indication for treatment intensification, and “off-label” use can only explain a minor part of the supply shortage.

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.