A lot of Americans with diabetes are turning to a new group of injected drugs, such as Ozempic (semaglutide) and Mounjaro (tirzepatide), which are big hits.
A new study, however, shows that half of the people who use these “second line” drugs, which are in a group called GLP-1 RAs, stop taking them within a year.
According to the experts, the main cause was stomach problems like nausea, vomiting, and diarrhea.
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“Discontinuation is not good. “It happens with all five types of diabetes drugs, but we see it a lot more with people who are taking GLP-1 RAs,” said David Liss, the lead author of the study. He works at the Feinberg School of Medicine at Northwestern University in Chicago as a research associate professor of general internal medicine.
The report came out in the American Journal of Managed Care on Tuesday.
Metformin is often the first drug given to people who have just been identified with Type 2 diabetes to help them control their blood sugar.
Metformin is sometimes not enough, so patients move on to a second-line drug like a GLP-1 RA.
This group also includes exenatide (Byetta), liraglutide (Saxenda), and dulaglutide (Trulicity), along with Mounjaro and Ozempic.
In the new study, Liss’s group looked at how well more than 82,000 diabetes patients from 2014 to 2017 stuck to their prescriptions.
They looked at people who were taking one of five types of diabetes medicines, but not insulin. The study found that about 38% of people who switched from metformin to another drug stopped taking it within a year.
The experts said that number went up to 50% for those who were switched to a GLP-1 RA.
“Presumably, the doctor is saying, ‘You need to start a new medication to control your Type 2 diabetes,’ and then within a year, half of them just stop and don’t start another one, and that’s not a good thing,” Liss said in a Northwestern report.
The study wasn’t meant to find out exactly why people stopped taking the drugs, but the researchers did say that stomach problems probably played a part.
They can also happen to people who don’t have diabetes who take a GLP-1 RA to lose weight.
Wegovy (a different form of semaglutide) and Zepbound (a different form of tirzepatide), two new GLP-1 RA drugs, are meant to help people lose weight.
“We know there are gastrointestinal side effects for these drugs that are currently in the news, both for patients with diabetes and patients attempting to lose weight,” said Liss.
Quitting a GLP-1 RA drug doesn’t always cause a spike in blood sugar right away, but Liss warned that “discontinuation still puts these patients at greater risk for downstream hospitalizations related to diabetes.”
His team is worried that a lot of people will stop taking their GLP-1 RA without telling their doctor. That could be a bad thing to do.
“Our results may represent a ‘wake-up call’ for clinicians that many of their patients were not taking the medicines that were prescribed,” said Liss. “While we don’t know if providers were aware of the discontinuation events observed in this study, our results highlight the need for ongoing communication between patients and prescribers over time — around medication benefits, side effects and costs — not just at the time of prescribing.”