Prescribing patterns of glucagon-like peptide-1 receptor agonists in the Swedish capital region-a register-based cross-sectional study.

Purpose: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have gained considerable media attention, but there is limited knowledge about those receiving the drugs. This study aimed to assess demographic characteristics and previous diagnoses in patients dispensed GLP-1 RAs in Region Stockholm, Sweden, between 2019 and 2023, with a focus on off-label prescribing.

Methods: This was a register-based cross-sectional study including all inhabitants in Region Stockholm, Sweden, who were dispensed a GLP-1 RA between 2019 and 2023. Patient characteristics were assessed through record linkage with administrative healthcare data on demographics, healthcare consultations, diagnoses, and other dispensed drugs.

Results: The prevalence proportion of GLP-1 RA dispensations in Region Stockholm increased from 4.7 patients/1000 inhabitants in 2019 to 17.5 patients/1000 inhabitants in 2023, and the incidence proportion from 1.8 patients/1000 inhabitants in 2019 to 7.4 patients/1000 inhabitants in 2023. GLP-1 RAs have become more common among a younger and female population, with women constituting 47% of incident patients in 2019 compared to 53% in 2023. The most common diagnosis shifted from type 2 diabetes mellitus (T2DM) (82% in 2019) to obesity (47% in 2023). During the same period, obesity without T2DM notably increased from 10 to 31%. Almost one-third (31%) of all patients dispensed the drugs in 2023 had no recorded diagnosis of either diabetes or obesity, compared to 8% in 2019.

Conclusion: This study showed an increase in the dispensation of GLP-1 RA, with characteristics of patients changing towards a higher degree of off-label use. The effectiveness and safety of the increasing prescriptions warrant future studies.