Presentation (CTI)

OBJECTIVES: Glucagon-like peptide-1 receptor agonists (GLP1s) are effective in treating diabetes and assisting in weight loss yet reports of suicidal ideations (SI) among patients have raised concerns about potential side effects. This study examined whether the prevalence of SI increased after initiating a GLP1 and whether prevalence of SI differed by GLP1 indication.
METHODS: Data were sourced from OM1 Real-World Data Cloud (Boston, MA), a deterministically linked, multi-source dataset derived from EHR and claims records. The index date was the date of the first GLP1 prescription. SI assessments (affirmed or denied) were identified from clinical notes using automated text extraction. Patients assessed for SI one year before and after the index date who had no record of previous prescriptions for other second-line type II diabetes or weight loss medications were included. McNemar’s test was used to assess change in affirmed SI prevalence before and after the index date. Chi-square tests were used to compare prevalence of affirmed SI by GLP1 indication (diabetes or weight loss).
RESULTS: There were 2,685 patients prescribed GLP1s who met inclusion criteria. There was no statistical difference (χ²=0.45, df=1, p=0.500) between the percentage of patients with SI in the year before GLP1 initiation (2.4%) versus after initiation (2.2%). Most patients (58.3%) who had SI after initiating a GLP1 experienced SI in the year prior to initiating GLP1 treatment. There were 581 (21.6%) patients prescribed GLP1s for weight loss on the index date, 2,104 (78.4%) were prescribed GLP1s for diabetes. The prevalence of SI before (χ²=0.87, df=1, p=0.350) and after (χ²=0.10, df=1, p=0.755) the index date did not differ by GLP1 indication.
CONCLUSIONS: No change in SI prevalence was observed after initiation of GLP1 medications and SI prevalence did not differ by GLP1 indication. Prior SI was observed in most patients who reported SI after GLP1 initiation.