CVD remains the leading cause of death in T2D, and treatment costs continue to rise. An large observational cohort study, published in Diabetes Research and Clinical Practice assessed outcomes associated with once-weekly GLP-1 RAs significantly reduce cardiovascular (CV) in U.S. Medicare beneficiaries with T2D and established ASCVD.
The analysis included 398,470 patients using Medicare fee-for-service claims data from 2006 to 2022. Propensity score matching compared once-weekly GLP-1 RAs with other non-insulin glucose-lowering therapies (ONIGLTs). GLP-1 RA treatment was associated with reduced cardiovascular events, with hazard ratios ranging from 0.72 to 0.88 (P<0.05). Healthcare use was also lower, with fewer ASCVD-related visits (IRR 0.877; 95% CI, 0.839–0.917; P<0.001) and lower total medical costs (mean ratio 0.882; 95% CI, 0.585–0.907; P<0.001).
Among the GLP-1 RAs, semaglutide provided the most favorable outcomes, reducing CV risk compared with both SGLT2 inhibitors (HRs 0.80–0.85; P < 0.05) and DPP-4 inhibitors (HRs 0.58–0.73; P < 0.001). These findings emphasize guideline recommendations favoring GLP-1 RAs for patients with T2D and ASCVD, while highlighting their economic value in a real-world Medicare setting.
