Background: SGLT-2i and GLP-1RA are recommended for persons with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD); for those prescribed, little is known about reasons for discontinuation.
Methods: From the COORDINATE-Diabetes randomized trial database, the frequency and reasons for discontinuation of SGLT2i or GLP-1RA were analyzed.
Results: 1045 participants were enrolled 7/2019 to 5/2022; 290 (27.8%) were prescribed SGLT-2i of whom 67 (23.1%) discontinued; and 118 (11.3%) were prescribed GLP-1RA of whom 38 (32.2%) discontinued. Race, age and sex did not differ among those discontinuing either class. Medicare was more common among those discontinuing vs persisting with SGLT-2i (71.4 vs. 58.1%; p=0.058) and GLP-1RA (71.1 vs. 49.4%); p=0.027). Cost, side effects, and patient choice were common reasons for discontinuation.
Conclusion: Up to one-third of participants discontinued either an SGLT-2i or GLP-1RA within 12 months of initiating. Efforts to address modifiable contributors to discontinuation are required.
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