Presentation (CTI)

OBJECTIVES: Apply prevalent new-user cohort design to real-world data for comparison of incidence of nutrition deficiencies in patients using and not using Glucagon-like peptide-1 receptor agonists (GLP-1RAs).
METHODS: Cohorts of patients with type 2 diabetes prescribed metformin with or without an additional prescription for GLP-1RAs between 07/2017-06/2023 were formed from Inovalon Insights claims data. Patients using insulin, with type 1 diabetes, without continuous 6-months of enrollment at baseline or with prior diagnosis of nutrition deficiency were excluded. Patients were observed longitudinally to identify when GLP-1RAs were prescribed. Monthly hazard for GLP-1RA prescriptions were calculated for all patients using sociodemographic variables, comorbidities, and baseline health care costs. Each GLP-1RA patient was matched to the closest non-GLP-1RA patient using hazard of GLP-1RA prescription with exact match on cohort year and the months of metformin use.
RESULTS: Of 4,557 GLP-1RA users that met the inclusion criteria, 4,505 were matched to a GLP-1RA non-users. Matching reduced the standardized mean difference between GLP-1RA users and non-users to less than 0.1 for almost all variables. Comparison reveals that GLP-1RA users had slightly higher incidence of nutrition deficiencies in the year following GLP-1RA prescription than non-users (18.6% vs 16.5% p<0.01).
CONCLUSIONS: Application of prevalent new-user study design to claims data demonstrates the feasibility of developing comparisons of patients using and not using a medication while mitigating time-zero bias, while showing that GLP-1RA users had higher incidence of nutrition deficiencies than non-users (18.6% vs 16.5%) . This statistical methodology can support future analysis of real-world nutrition data. incidence of nutrition deficiencies in the year following GLP-1RA prescription than non-users (18.6% vs 16.5% p<0.01).