Current medical research and opinion · 2025
Racial/ethnic differences in the use of glucagon-like peptide-1 receptor agonists (GLP-1 agonists) for atherosclerotic cardiovascular disease (ASCVD) benefit in patients with type 2 diabetes.
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Ahmed Fahamina, Borghol Amne, Grady Madison, Rivera Lauren, Meyers Sierra, Olet Susan
Аннотация
PURPOSE: According to the current guidelines, glucagon-like peptide-1 receptor agonists (GLP-1 agonists) are recommended for the treatment of Type II diabetes mellitus (T2DM) in patients who are at risk for developing atherosclerotic cardiovascular disease (ASCVD). The black population is at a greater risk of developing ASCVD. This research intends to investigate the prescribing patterns of GLP-1 agonists amongst blacks compared to patients of other races and ethnicities.
METHODS: This is a retrospective study of patients who were 18 years or older with a diagnosis of T2DM and were prescribed GLP-1 agonists and at Ochsner Health System from January 2019 to July 2023. The primary outcome was comparison of major adverse cardiovascular events (MACE): myocardial infarction, stroke, and inpatient mortality among the three study groups. Secondary outcomes included differences in clinical outcomes (A1C reduction, BMI reduction) in patients using GLP-1 agonists compared to patients not receiving these agents.
RESULTS: Of 92,861 patients who met the inclusion criteria, the proportion of patients prescribed GLP-1 agonists by race included black 12,225 (33.2%), white 17,931 (34.5%), and others 2,834 (71.5%). For the primary outcomes among patients prescribed GLP-1 agonists, there was a significant difference with patients with black race having a lower proportion of inpatient mortality and composite outcome [1.8%, 2.8%, respectively] compared to patients of white race [2.6%, 4%, respectively], (p < .0001). For the secondary outcomes, from baseline to 48 months, patients prescribed GLP-1 agonists with black race had a greater reduction in A1C than patients with white race [-0.80 vs-0.56] while patients with white race had a greater reduction in BMI [-1.74 vs -1.40], (p < .0001).
CONCLUSION: The use of GLP-1 agonists has been shown to improve various clinical outcomes. Further research may reveal methods to increase the use of these agents, which may reduce disease-related complications especially for the minority population.
METHODS: This is a retrospective study of patients who were 18 years or older with a diagnosis of T2DM and were prescribed GLP-1 agonists and at Ochsner Health System from January 2019 to July 2023. The primary outcome was comparison of major adverse cardiovascular events (MACE): myocardial infarction, stroke, and inpatient mortality among the three study groups. Secondary outcomes included differences in clinical outcomes (A1C reduction, BMI reduction) in patients using GLP-1 agonists compared to patients not receiving these agents.
RESULTS: Of 92,861 patients who met the inclusion criteria, the proportion of patients prescribed GLP-1 agonists by race included black 12,225 (33.2%), white 17,931 (34.5%), and others 2,834 (71.5%). For the primary outcomes among patients prescribed GLP-1 agonists, there was a significant difference with patients with black race having a lower proportion of inpatient mortality and composite outcome [1.8%, 2.8%, respectively] compared to patients of white race [2.6%, 4%, respectively], (p < .0001). For the secondary outcomes, from baseline to 48 months, patients prescribed GLP-1 agonists with black race had a greater reduction in A1C than patients with white race [-0.80 vs-0.56] while patients with white race had a greater reduction in BMI [-1.74 vs -1.40], (p < .0001).
CONCLUSION: The use of GLP-1 agonists has been shown to improve various clinical outcomes. Further research may reveal methods to increase the use of these agents, which may reduce disease-related complications especially for the minority population.