IMPACT OF GLP-1 RECEPTOR AGONIST (GLP-1 RAS) PERSISTENCE VERSUS DISCONTINUATION ON CARDIOMETABOLIC MEASURES IN POLYCYSTIC OVARY SYNDROME (PCOS) OVER A TWO-YEAR FOLLOW-UP
Author(s)
Isabelle Winer, PhD, Maryam Ajose, MPH, Robert Sedgley, MS, Brendan Limone, PharmD, Jessamine Winer-Jones, PhD, Natalia Coenen, MPH, Janna Manjelievskaia, PhD;
Veradigm, Raleigh, NC, USA
Veradigm, Raleigh, NC, USA
OBJECTIVES: GLP-1 RAs are a viable treatment option for PCOS, facilitating weight loss and improving metabolic markers. We sought to understand the impact of semaglutide and dual GIP/GLP-1 RA tirzepatide on cardiometabolic markers among females with PCOS.
METHODS: Data from the Veradigm Network EHR linked to Komodo claims were used to select females aged 12-50 with ≥1 of the following criteria between 01/01/2020-04/30/2025: ≥1 claim/EHR record with ICD-10-DX for PCOS (E282) or ≥1 claim/EHR record for PCOS composite criteria of amenorrhea (N91.2), irregular menstruation, unspecified (N92.6), oligomenorrhea (N91.5), and/or hirsutism (L68.0), and/or hyperandrogenism (E28.1). The earliest of ≥1 new prescription for semaglutide or tirzepatide after the PCOS diagnosis was index. Continuous claims enrollment for 12 months pre- and 24 months post-index was required. Those with pregnancy/delivery, bariatric surgery or other GLP-1 RA use were excluded. BMI, weight, HbA1c, triglycerides, total cholesterol, LDL-C, and HDL-C were captured during the follow-up. Results were presented separately for persistent vs. discontinuing patients over a two-year follow-up.
RESULTS: Of 710 eligible for analysis, 124 (18%) remained persistent for two years. Average time of persistence was 10 months. Patients were aged 38.6(8.5) on average, majority White (50.4%), non-Hispanic (59.2%), with mean(SD) BMI 36.1(4.6) as of index. Over a third had type 2 diabetes, 17.2% were treated with metformin and 54.4% with spironolactone at baseline. Mean(SD) starting weight and Hba1c were 230.3 (48.7) and 6.1(1.4) overall; mean(SD) starting total cholesterol and triglycerides were 189.0(36.5) and 142.5(93.9). During follow-up, mean(SD) weight and A1c were 218.5(51.5) and 5.7(1.0) among persistent patients versus 223.4(48.0) and 6.0(1.4) among discontinuers. Total mean(SD) cholesterol decreased for both cohorts, while triglycerides decreased to 128.1(81.4) among persistent patients and returned to baseline for discontinuers 142.3(94.7).
CONCLUSIONS: Women with PCOS who newly initiate GLP-1 RAs and remain persistent long-term see sustained improvement in cardiometabolic measures compared to those who discontinue.
METHODS: Data from the Veradigm Network EHR linked to Komodo claims were used to select females aged 12-50 with ≥1 of the following criteria between 01/01/2020-04/30/2025: ≥1 claim/EHR record with ICD-10-DX for PCOS (E282) or ≥1 claim/EHR record for PCOS composite criteria of amenorrhea (N91.2), irregular menstruation, unspecified (N92.6), oligomenorrhea (N91.5), and/or hirsutism (L68.0), and/or hyperandrogenism (E28.1). The earliest of ≥1 new prescription for semaglutide or tirzepatide after the PCOS diagnosis was index. Continuous claims enrollment for 12 months pre- and 24 months post-index was required. Those with pregnancy/delivery, bariatric surgery or other GLP-1 RA use were excluded. BMI, weight, HbA1c, triglycerides, total cholesterol, LDL-C, and HDL-C were captured during the follow-up. Results were presented separately for persistent vs. discontinuing patients over a two-year follow-up.
RESULTS: Of 710 eligible for analysis, 124 (18%) remained persistent for two years. Average time of persistence was 10 months. Patients were aged 38.6(8.5) on average, majority White (50.4%), non-Hispanic (59.2%), with mean(SD) BMI 36.1(4.6) as of index. Over a third had type 2 diabetes, 17.2% were treated with metformin and 54.4% with spironolactone at baseline. Mean(SD) starting weight and Hba1c were 230.3 (48.7) and 6.1(1.4) overall; mean(SD) starting total cholesterol and triglycerides were 189.0(36.5) and 142.5(93.9). During follow-up, mean(SD) weight and A1c were 218.5(51.5) and 5.7(1.0) among persistent patients versus 223.4(48.0) and 6.0(1.4) among discontinuers. Total mean(SD) cholesterol decreased for both cohorts, while triglycerides decreased to 128.1(81.4) among persistent patients and returned to baseline for discontinuers 142.3(94.7).
CONCLUSIONS: Women with PCOS who newly initiate GLP-1 RAs and remain persistent long-term see sustained improvement in cardiometabolic measures compared to those who discontinue.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO11
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)