Causes and consequences of discontinuation of GLP1RAs or tirzepatide - PubMed
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- #GLP1R agonists
- #discontinuation
- #tirzepatide
- GLP1 receptor agonists and tirzepatide are key treatments for type 2 diabetes and obesity due to their glycaemia-lowering, weight-lowering, and cardiorenal benefits.
- Real-world persistence on these drugs is often suboptimal, with many discontinuing within the first year of therapy.
- Common reasons for discontinuation include gastrointestinal adverse effects, less-than-desired efficacy, high cost, and fear of rare adverse effects.
- Discontinuation typically leads to weight regain and deterioration of cardiometabolic risk factors like poor glycaemic control.
- Repeated cycles of initiation, interruption, and re-initiation may cause body weight and HbA1c fluctuations, increasing cardiovascular and microvascular risk.
- The lack of anti-atherosclerotic effects of incretin-based medications might elevate cardiovascular risk, especially after discontinuation.
- Limited data are available on hard outcomes post-discontinuation, highlighting a need for further research.
- Long-term implications include impacts on T2DM care, weight management, and cardiorenal disease prevention in patients with T2DM and/or obesity.