GLP-1 receptor agonists have become blockbuster drugs for weight loss, diabetes, cardiovascular risk reduction, kidney health, and just recently, metabolic dysfunction-associated steatohepatitis (MASH) . Randomized controlled trials (RCTs) launched these therapies, but leave gaps in our understanding about how they work in the real-world—and who they work for.
Together with Humbi.ai, we analyzed claims data to describe characteristics, treatment patterns and outcomes among Medicare FFS beneficiaries who started using GLP-1s. This population is more representative of US seniors than typical trial populations, and specifically includes more rural seniors—who are generally underrepresented in RCTs but face higher cardiometabolic risk.
We found semaglutide use surged over time, becoming the most prescribed GLP-1 RA in 2021, with primary care providers doing most of the prescribing. This data provides real-world benchmarks for myocardial infarction and overall survival in a Medicare population, as well as some evidence that semaglutide and tirzepatide may have particularly favorable profiles for cardiovascular risk reduction and overall survival in a real-world setting.
Other RWE has highlighted different gaps. A recent study of patients from the Cleveland Clinic found patients taking semaglutide or tirzepatide lost significantly less weight than seen in trials—likely due to differences in drug utilization. And another ISPE poster using TriNetX data found substantial GLP-1 treatment heterogeneity for weight loss with older adults, women, White patients, non-diabetic patients, and those with higher baseline BMI experiencing greater treatment effects.
Want to use RWD to bridge gaps between trial results and real-world impact? Contact Landmark for the real-world answers you need, or explore our other RWE services.