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Emergence of New Medications in Weight Loss and Diabetes Management
Recent research from Mass General Brigham reveals significant shifts in the medications prescribed for weight loss and type 2 diabetes management. The investigation analyzed claims data from nearly 2 million individuals between 2021 and 2023, illustrating a trend towards newer treatments. Notably, the utilization of recent medications, particularly tirzepatide, has surged. This drug, marketed as Mounjaro for diabetes and Zepbound for weight loss, has contributed to a decline in the reliance on older medications like metformin, sulfonylureas, and insulin. The findings are presented in the journal Annals of Internal Medicine.
“These results indicate a rapidly evolving approach to prescribing medications for managing glucose levels and promoting weight loss,” explained Dr. John W. Ostrominski, the study’s lead author and a member of various divisions at Brigham and Women’s Hospital, part of the Mass General Brigham healthcare system. “This trend likely mirrors growing insights, heightened emphasis on obesity treatment, and updates in management guidelines for these conditions.”
The study, sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases, focused on individuals with commercial insurance. The researchers found that in January 2021, around half of the weight loss medications initiated by individuals without diabetes were based on GLP-1 receptor agonists (GLP-1RAs), including drugs like semaglutide and tirzepatide. By December 2023, this figure surged to almost 90%, with tirzepatide representing the most frequently prescribed option at 31%. Meanwhile, the use of other weight loss treatments, such as phentermine and liraglutide, has diminished.
Among those diagnosed with type 2 diabetes, the uptake of GLP-1RAs increased from 13% in January 2021 to 35% by the end of 2023. Metformin, previously the most prescribed glucose-lowering medication at 30% in January 2021, fell to 19% by December 2023.
When comparing the adoption rates of tirzepatide following its approval to those of other recently licensed medications for type 2 diabetes or obesity, the researchers observed that tirzepatide’s increase in use was both sharper and more sustained.
“The immediate and robust rise in tirzepatide use post-approval is crucial for stakeholders—patients, clinicians, researchers, and policymakers alike—to recognize,” noted Ostrominski. “The increasing familiarity and application of tirzepatide and GLP-1RAs highlight the necessity for healthcare professionals to understand these treatments better, for researchers to investigate their long-term impacts, and for health policy frameworks to ensure continued access and affordability.”
Nevertheless, the researchers acknowledge certain limitations in their findings, particularly regarding the generalizability of the data derived from commercially insured adults in the U.S. to broader populations and international settings.
“While we currently lack long-term outcome data for tirzepatide analogous to what exists for other GLP-1RAs, initial findings appear promising,” Ostrominski said. “Future studies comparing the efficacy of tirzepatide against semaglutide regarding glycemic control, weight management, and cardiovascular health will facilitate more informed decision-making between patients and clinicians about selecting the most appropriate medication.”
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