Theresa Hunter Gibble, Chanadda Chinthammit, Jennifer M Ward, Katherine Cappell, Robert Sedgley, Machaon Bonafede, Birong Liao, Emily R Hankosky
{"title":"Real-world use of tirzepatide among individuals without evidence of type 2 diabetes: Results from the Veradigm® database.","authors":"Theresa Hunter Gibble, Chanadda Chinthammit, Jennifer M Ward, Katherine Cappell, Robert Sedgley, Machaon Bonafede, Birong Liao, Emily R Hankosky","doi":"10.1111/dom.16330","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To understand real-world tirzepatide use among individuals without type 2 diabetes (T2D) diagnoses in a US electronic health record (EHR) database.</p><p><strong>Materials and methods: </strong>This retrospective, descriptive, cohort study used Veradigm's® Network EHR database linked with administrative claims. Adults (≥18 years) included had ≥1 tirzepatide prescription (index period: 13 May 2022-31 August 2023); continuous medical and pharmacy enrolment for ≥12 months pre-index; and no T2D diagnosis or baseline T2D medications except metformin (overall cohort). 'Anti-obesity medication (AOM)-eligible cohort' included individuals with body mass index (BMI) ≥30 or ≥27 kg/m<sup>2</sup> and ≥1 obesity-related complication (ORC) and ≥6 months of continuous post-index enrollment.</p><p><strong>Results: </strong>The overall cohort included 10,193 individuals (mean age: 45.0 years; female: 77.1%). Among 6623 individuals with BMI data, 5931 were AOM-eligible. Of these, 3470 had 6-month follow-up data (AOM-eligible cohort; ≥1 ORC: 76.5%; ≥2 ORCs: 51.8%). Treatment patterns at 6 months were assessed among 755 individuals with complete claims data in the AOM-eligible cohort. Most individuals (95.6%) were initiated on a tirzepatide dose of ≤5 mg. At the fifth prescription refill (n = 448), 91.1% were receiving tirzepatide doses of ≤10 mg. At 6 months, tirzepatide adherence was 55.5% and persistence was 54.2%. Among discontinued individuals (n = 346), 10.1% switched to an alternate AOM.</p><p><strong>Conclusions: </strong>Majority of individuals in the AOM-eligible cohort had ≥1 ORC, and half had ≥2 ORCs, indicating that in this study cohort tirzepatide was being used in people with multimorbidity. Tirzepatide dose escalation in this real-world cohort was slower than in clinical trials, which may have implications for its real-world effectiveness.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes, Obesity & Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dom.16330","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Real-world use of tirzepatide among individuals without evidence of type 2 diabetes: Results from the Veradigm® database.
Aims: To understand real-world tirzepatide use among individuals without type 2 diabetes (T2D) diagnoses in a US electronic health record (EHR) database.
Materials and methods: This retrospective, descriptive, cohort study used Veradigm's® Network EHR database linked with administrative claims. Adults (≥18 years) included had ≥1 tirzepatide prescription (index period: 13 May 2022-31 August 2023); continuous medical and pharmacy enrolment for ≥12 months pre-index; and no T2D diagnosis or baseline T2D medications except metformin (overall cohort). 'Anti-obesity medication (AOM)-eligible cohort' included individuals with body mass index (BMI) ≥30 or ≥27 kg/m2 and ≥1 obesity-related complication (ORC) and ≥6 months of continuous post-index enrollment.
Results: The overall cohort included 10,193 individuals (mean age: 45.0 years; female: 77.1%). Among 6623 individuals with BMI data, 5931 were AOM-eligible. Of these, 3470 had 6-month follow-up data (AOM-eligible cohort; ≥1 ORC: 76.5%; ≥2 ORCs: 51.8%). Treatment patterns at 6 months were assessed among 755 individuals with complete claims data in the AOM-eligible cohort. Most individuals (95.6%) were initiated on a tirzepatide dose of ≤5 mg. At the fifth prescription refill (n = 448), 91.1% were receiving tirzepatide doses of ≤10 mg. At 6 months, tirzepatide adherence was 55.5% and persistence was 54.2%. Among discontinued individuals (n = 346), 10.1% switched to an alternate AOM.
Conclusions: Majority of individuals in the AOM-eligible cohort had ≥1 ORC, and half had ≥2 ORCs, indicating that in this study cohort tirzepatide was being used in people with multimorbidity. Tirzepatide dose escalation in this real-world cohort was slower than in clinical trials, which may have implications for its real-world effectiveness.
期刊介绍：
Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.
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