OBJECTIVES: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are highly effective for glycemic control and weight loss; however high demand and off-label use have led to drug shortages. This research aims to characterize real-world utilization of GLP-1 RAs among US adults.

METHODS: Natural language processing was used to search and analyze Amplity Insights, a database composed of US-based transcribed physician notes from nearly 120,000 healthcare professionals across all 50 states and 2 US territories. Records from 1 January 2017 to 30 April 2024 were examined to identify patients who had received a GLP-1 RA, including specific agents (utilizing brand or compound name) or the class as a whole. Patient demographics, comorbidities, type(s) of GLP-1 RA received, and utilization for weight loss were summarized.

RESULTS: Out of a cohort of over 28 million patients, 91,526 (52.0% female) had been or were treated with a GLP-1 RA, with a mean (SD) age of 60.8 (12.7) years. In total, 90.9% of patients had diabetes, 42.0% were overweight or obese, and 39.2% had diabetes and were overweight or obese; only 2.7% were overweight or obese but did not have diabetes. Liraglutide was used most often (40.5%), followed by dulaglutide (35.4%), semaglutide (16.1%), and exenatide (10.3%); only 328 (0.4%) patients received tirzepatide.

CONCLUSIONS: In this real-world US cohort, GLP-1 RAs were overwhelmingly used in patients with diabetes. Exclusive use for weight loss was limited, which may be due in part to drug shortages and restrictions on insurance coverage for obesity/overweight, as US payers are already implementing policies to manage patient access to GLP-1 RAs. In future it is expected that GLP-1 RA use for weight loss will increase, as will utilization of tirzepatide. Increased uptake will provide more treatment options for persons living with obesity or overweight.