Real‐world persistence and dose titration of GLP ‐1 receptor agonists in type 2 diabetes: A UK population‐based cohort study by obesity and cardiovascular disease status

Abstract Aims Real‐world medication use varies across clinical trial and healthcare settings; therefore, we evaluated GLP ‐1 receptor agonist ( GLP ‐ 1RA ) persistence and dose titration among adults with type 2 diabetes in UK primary care, stratified by agent, obesity status, cardiovascular disease ( CVD ) history, and sex assigned at birth. Materials and methods Adults with type 2 diabetes initiating GLP‐1RAs between 1 March 2018 and 30 June 2023, with follow‐up ≥1‐year, were identified using the IQVIA Medical Research Data (IMRD) incorporating data from THIN, A Cegedim Database. The absolute 1‐year risk of discontinuation was estimated using the Aalen‐Johansen estimator, while multivariable cause‐specific Cox models assessed associations with patient characteristics. Dosing trajectories were characterised across individual prescriptions during the first therapy year. Results Among 8200 GLP‐1RA initiators (46.5% dulaglutide, 38.7% semaglutide), the 1‐year discontinuation risk was 41.1% (95% CI 40.1–42.2), higher among those without obesity (BMI