GLP-1 agonists were most frequently prescribed to adolescents and adults by endocrinologists and nurse practitioners, respectively.
Dispensing of glucagon-like peptide-1 receptor agonists (GLP-1RAs) increased substantially between 2020 and 2023 among adolescents and young adults in the United States, according to results of a study published in JAMA.
GLP-1RAs were approved for the management of type 2 diabetes in 2005 and approved for weight loss in 2014. Dispensing trends can help illuminate the long-term safety, efficacy, and cost-effectiveness of these drugs.
To evaluate GLP-1RA use trends among adolescents and young adults, researchers from the University of Michigan Medical School sourced data from the IQVIA Longitudinal Prescription Database. Prescriptions of GLP-1RAs among adolescents aged 12 to 17 years and young adults aged 18 to 25 years between 2020 and 2023 were evaluated.
Data for dulaglutide, exenatide, liraglutide, semaglutide, and tirzepatide were included. Both liraglutide and semaglutide are approved for weight management among adolescents and adults, whereas tirzepatide is only approved for weight managementamong adults.
Over the 4-year period, 30,947 adolescents (mean age, 15.2 years) and 162,439 young adults (mean age, 22.4 years) received GLP-1RAs. Among the adolescents and young adults, 60.0% and 76.4% were girls and women, respectively; 45.7% and 46.3% lived in the South; and, 48.0% and 26.3% had Medicaid insurance, respectively.
Efforts to promote safe and appropriate prescribing should include endocrinologists, family medicine physicians, and nurse practitioners given their prominent roles in GLP-1RA dispensing.
Among adolescents, the most common GLP-1RAs were liraglutide (25.9%), semaglutide for type 2 diabetes (24.7%), dulaglutide (20.7%), and semaglutide for weight management (19.5%). Among adults, the most common GLP-1RAs were semaglutide for type 2 diabetes (34.0%), semaglutide for weight management (21.7%), and tirzepatide (19.6%).
Adolescents were most frequently prescribed GLP-1RAs by endocrinologists (32.7%) and nurse practitioners (26.4%), whereas adults received GLP-1RAs from nurse practitioners (33.0%) and family medicine practitioners (22.9%).
From 2020 and 2023, the rate of GLP-1RA prescriptions increased by 594.4% whereas dispensing of drugs other than GLP-1RAs decreased by 3.1%. Stratified by gender, GLP-1RA dispensing increased more among girls vs boys (587.5% vs 503.8%) and women vs men (659.4% vs 481.1%).
The number of prescriptions for semaglutide for weight management increased sharply in 2023 among adolescents. For adults, dispensing of tirzepatide and semaglutide for weight management increased sharply in 2022 and 2023, respectively.
The major limitation of this study was the lack of data about prescription indication.
The researchers concluded, “Efforts to promote safe and appropriate prescribing should include endocrinologists, family medicine physicians, and nurse practitioners given their prominent roles in GLP-1RA dispensing.”
