GLP-1 Receptor Agonist Prescription Patterns in the All of Us Research Program

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Abstract Importance Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are fast-growing treatments for type 2 diabetes, obesity, and sleep apnea and are under investigation as potential treatments for many other conditions. The National Institutes of Health’s (NIH’s) All of Us Research Program offers a robust observational data source for studying questions related to GLP-1RA use in real-world settings. Objective This article describes key characteristics of All of Us participants who have been prescribed GLP-1RAs. The goals are to present the utility of the All of Us data and describe the strengths and limitations of using this resource for future research on GLP-1RAs. Design Using the All of Us Controlled Tier Curated Data Repository version 8 (CDRv8), we provide a descriptive analysis of the cohort with GLP-1RA records using cross-sectional surveys, longitudinal electronic health record (EHR) data, and longitudinal Fitbit data. Setting The All of Us Research Program is a large, federally funded, longitudinal cohort study established in 2018 by NIH. Recruitment efforts are nationwide and target a range of populations to advance precision medicine for all. Participants Participants are U.S. residents, aged 18 or older at the time of study consent, who were enrolled between May 6, 2018, and October 1, 2023. Exposures The GLP-1RA cohort included participants with at least two GLP-1RA prescription records on different days at any time point based on their EHRs. Main Outcomes Frequencies and medians for a range of sociodemographic characteristics, health care utilization patterns, comorbid conditions, GLP-1RA prescription trends, laboratory and observation availability, and Fitbit data. Results The All of Us GLP-1RA cohort is large (n=15 477), with high data availability across a range of relevant data types. These participants are older and have more comorbid conditions than the entire CDRv8 population. Prescription trends indicate rapid uptake of GLP-1RA drugs since 2014. Conclusions and Relevance All of Us CDRv8 is a valuable resource for research on GLP-1RAs across a large, heterogeneous cohort of participants. The variety and availability of data offer many possibilities for future observational, real-world research to address unanswered questions about GLP-1RA use and replicate recent findings generated from other datasets. Key points Question What data are available and what are the patterns of GLP-1 receptor agonist (GLP-1RA) prescriptions among participants in the All of Us Research Program? Findings In this descriptive cohort study of 633 534 All of Us participants, 15 477 participants had at least two records of GLP-1RA prescriptions. These participants tended to be older, have more comorbid conditions, and have higher health care utilization than the All of Us population as a whole. Meaning The All of Us Research Program has a robust array of data to support observational studies of people receiving GLP-1RA prescriptions.

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