CHAPEL HILL, NC — Incretin-based therapies for the management of Type 2 diabetes (T2D) have become a well-established class of drugs within the VHA, according to a new study.
Glucagon-like peptide-1 receptor agonists (GLP-1RA) and dipeptidyl peptidase-4 inhibitors (DPP-4i) are incretin-based therapies commonly used in the management of type 2 diabetes, wrote University of North Carolina at Chapel Hill-led researchers. The Orlando, FL, VA Healthcare System and the University of Central Florida College of Medicine in Orlando also participated in the study.
“Public interest in GLP-1RA soared after discovering their ability to lower body weight in patients without diabetes,” the authors pointed out.
The study sought to examine recent trends in usage of GLP-1RA and DPP-4i in the VHA. To do that, the study team extracted GLP-1RA and DPP-4i prescriptions from the national VHA Corporate Data Workhouse (CDW) between fiscal years (FYs) 2011 to 2021, which encompass medication class, name, dosage, date of filled prescription and patients’ characteristics.
Results indicated that more than 3 million prescriptions for DPP-4i and about 2.2 million prescriptions for GLP-1RA were filled during FY 2011 to 2021. “More patients were prescribed DPP-4i (273,002 subjects) compared with GLP-1RA (157,209 subjects) from FY 2011 to 2021”, the researchers noted.
Overall, the study in the Journal of Pharmacy Technology found that 10.7% of veterans used DPP-4i for 90 days or less in comparison to 9.1% in GLP-1RA (P < 0.001). “The proportion of patients prescribed DPP-4i who were 75 years of age or older was relatively stable over the years 2011 to 2021 (mean proportion = 19%),” they said. “However, the proportion of patients who were 75 years of age or older prescribed GLP-1RA increased from 4.2% in 2011 to 16.9% in 2021.”1
The study concluded that incretin-based therapies have become a well-established class of drugs within the VHA. “Even though DPP-4i usage in older adults has remained stable over the past 10 years, prescriptions for GLP-1RA in older adults have increased multifold over the last few years, which might be attributed to recent trial evidence showing benefit in cardiovascular outcomes and weight reduction,” the authors wrote.
- Krishnan A, Suryanarayanan SK, Mansi IA. Utilization of Glucagon-Like Peptide-1 Receptor Agonist and Dipeptidyl Peptidase-4 Inhibitors at the Veterans Health Administration. J Pharm Technol. 2024 Oct;40(5):223-229. doi: 10.1177/87551225241266773. Epub 2024 Jul 27. PMID: 39391328; PMCID: PMC11462932.
