Mody Reema, Desai Karishma, Teng Chia-Chen, Reznor Gally, Stockbower Grace, Grabner Michael, Benneyworth Brian D
Eli Lilly and Company, Indianapolis, IN, USA.
Carelon Research, Wilmington, DE, USA.
Diabetes Ther. 2025 Feb;16(2):307-327. doi: 10.1007/s13300-024-01684-6. Epub 2025 Jan 10.
The study objective was to describe characteristics and utilization patterns of tirzepatide users with type 2 diabetes (T2D) using the Healthcare Integrated Research Database in the USA.
Adults (≥18 years) included had T2D diagnosis; ≥1 tirzepatide claim (May 2022-January 2023; first claim date = index date); and continuous medical and pharmacy enrollment during the 6-month baseline and follow-up periods from the index date. Baseline demographics, clinical characteristics, and 6-month follow-up dosing and treatment patterns were summarized descriptively.
The study included 15,665 patients with T2D initiating tirzepatide (mean age: 53.2 years; 58.5% women; 76.7% non-Hispanic white). During the 6-month baseline period, hypertension (69.2%), dyslipidemia (69.2%), overweight/obesity (58.4%), and obstructive sleep apnea (22.8%) were commonly reported comorbidities. Over half of the patients (51.2%) had used glucagon-like peptide-1 (GLP-1) receptor agonist (RA) before initiating tirzepatide. The mean glycated hemoglobin (HbA1c) was 7.6% (n = 5175), and 58.4% of these patients had HbA1c ≥7%. The mean body mass index (BMI) was 38.7 kg/m (n = 3459), and 87.8% of these patients either had Class 1, 2, or 3 obesity. Among patients with a single prescription on each fill date (N = 14,986), 84.1% initiated tirzepatide at ≤5 mg dose. During sixth prescription refill (n = 7304), 56.5% were receiving tirzepatide doses of <10 mg. During the 6-month follow-up period, 69.6% of patients had ≥1 dose escalation and 17.2% had ≥1 dose de-escalation. The mean time to first dose escalation was 59.1 days and first dose de-escalation was 104.8 days. Tirzepatide adherence (proportion of days covered [PDC] ≥80%) was 57.5% and persistence (45-day gap) was 73.3% at 6 months. Of patients who discontinued tirzepatide (n = 4177; 26.7%), 29.1% re-initiated tirzepatide (45-day gap).
Patients with T2D initiating tirzepatide had multimorbidity; uncontrolled diabetes; and mean BMI was consistent with Class 2 obesity. Patients showed favorable tirzepatide adherence and persistence profiles, and the majority remained at <10 mg doses during the 6-month follow-up period.
本研究的目的是利用美国医疗综合研究数据库描述使用替尔泊肽的2型糖尿病（T2D）患者的特征和用药模式。
纳入的成年人（≥18岁）患有T2D诊断；有≥1次替尔泊肽报销记录（2022年5月至2023年1月；首次报销日期=索引日期）；并且在从索引日期开始的6个月基线期和随访期内持续进行医疗和药房登记。对基线人口统计学、临床特征以及6个月随访期的给药和治疗模式进行描述性总结。
该研究纳入了15665例开始使用替尔泊肽的T2D患者（平均年龄：53.2岁；58.5%为女性；76.7%为非西班牙裔白人）。在6个月的基线期，常见的合并症包括高血压（69.2%）、血脂异常（69.2%）、超重/肥胖（58.4%）和阻塞性睡眠呼吸暂停（22.8%）。超过一半的患者（51.2%）在开始使用替尔泊肽之前曾使用过胰高血糖素样肽-1（GLP-1）受体激动剂（RA）。平均糖化血红蛋白（HbA1c）为7.6%（n = 5175）；这些患者中58.4%的HbA1c≥7%。平均体重指数（BMI）为38.7kg/m²（n = 3459）；这些患者中87.8%患有1级、2级或3级肥胖。在每次配药日期有单次处方的患者中（N = 14986），84.1%开始使用≤5mg剂量的替尔泊肽。在第六次处方 refill时（n = 7304），56.5%的患者接受的替尔泊肽剂量<10mg。在6个月的随访期内，69.6%的患者有≥1次剂量增加，17.2%的患者有≥1次剂量减少。首次剂量增加的平均时间为59.1天，首次剂量减少的平均时间为104.8天。替尔泊肽的依从性（覆盖天数比例[PDC]≥80%）在6个月时为57.5%，持续性（45天间隔）为73.3%。在停用替尔泊肽的患者中（n = 4177；26.7%），29.1%重新开始使用替尔泊肽（45天间隔）。
开始使用替尔泊肽的T2D患者患有多种合并症；糖尿病未得到控制；平均BMI与2级肥胖一致。患者表现出良好的替尔泊肽依从性和持续性特征，并且在6个月的随访期内大多数患者的剂量仍<10mg。
