In the last four decades, the discovery and development of glucagon-like peptide 1 receptor agonists (GLP-1RAs) reshaped the landscape of diabetes and weight management.
These groundbreaking medications, initially approved for patients with type 2 diabetes, are now revolutionizing chronic disease treatment through their metabolic, hormonal, and anti-inflammatory effects, becoming vital tools in addressing conditions like cardiovascular disease, nonalcoholic fatty liver disease, osteoarthritis, and more.
In this exclusive report, Cure, a healthcare innovation ecosystem in New York City, and the Deerfield Institute unveil the results of a specialty physician survey, shedding light on their current prescribing of GLP-1RA medications, the challenges they face, and their expectations for future clinical applications of these drugs.
Four decades ago, researchers made a stunning discovery: the existence of a hormone called glucagon-like peptide 1 (GLP-1).
They quickly realized that this hormone prompts insulin release in the body and helps to lower blood sugar. The translation of the discovery into therapies has transformed diabetes management, beginning with the approval of exenatide, the first GLP-1 receptor agonist (GLP-1RA), in 2005 by the U.S. Food and Drug Administration (FDA).
In the years since coming to market, GLP-1RA therapeutics development and adoption has exploded, with six now approved by the FDA. In the last four years specifically, the number of patients who don’t have diabetes taking these medications has increased 700 percent.
Much of this growth is due to the effectiveness of GLP-1RA medications as weight loss drugs. On average, patients can lose 10 to 20 percent of their body weight while taking these medications.
However an increasing number of patients are also taking GLP-1RAs for “off-label” conditions that are neither type 2 diabetes nor obesity. Recent research suggests that GLP-1 has an even more complex wewillcure.com role in the body than previously thought, including tamping down inflammation and interacting with complex biological systems in the brain and heart. Each of these roles opens up potential new pathways for chronic disease management.
Researchers have found diseases including cardiovascular disease, non-alcoholic fatty liver disease, diabetic chronic kidney disease, osteoarthritis, autoimmune disease, alcohol use disorder and more could be positively impacted by GLP-1RA therapy. While some of these conditions improved secondary to weight loss, other conditions are impacted directly by GLP-1RA’s mechanism of action in the body.
The prospect of having a new medication to treat multiple chronic conditions is exciting, but more research is still needed. GLP-1RAs are only approved by the FDA for the treatment of diabetes, weight loss and, recently, obstructive sleep apnea. For all other indications, physicians must prescribe these medications “off-label.”
To understand current physician prescribing practices of off-label GLP-1RA uses, Cure, a healthcare innovation ecosystem in New York City, in conjunction with the Deerfield Institute, a division of Deerfield Management Company, an affiliate of Cure, surveyed 122 physicians across the specialties of gastroenterology, addiction medicine, cardiology, neurology and orthopedics.
The survey focused on these specialties because they all interact with patients who may be eligible to use GLP-1RA medications “offlabel.” The results, reported here for the first time, show that physician prescribing for “off-label” use of GLP-1RA medications is increasingly common, and often beneficial to patients. Still, physicians are wary of lack of inclusion of GLP-1RA drugs in clinical guidelines yet are optimistic that more research and evidence will be forthcoming.