Constipation Common Among GLP-1 Users, but Risk of New-Onset Cases Remains Low: Study
USA: Researchers have found in a recent study that nearly one in three patients discontinued glucagon-like peptide-1 (GLP-1) receptor agonist therapy within six months of starting treatment. Adverse drug reactions, medication cost, and non-adherence were the leading reasons for discontinuation. The findings highlight important real-world barriers to long-term GLP-1 use and highlight the need for strategies to improve treatment persistence.
The findings, published in Diabetes, Obesity and Metabolism, are based on a study led by Jessica Van Laren, PharmD, of the Pharmacy Department at Kaiser Permanente Colorado in Aurora, Colorado, USA, and colleagues. The researchers evaluated real-world rates of early GLP-1 discontinuation, identified the reasons patients stopped treatment, and examined patient characteristics associated with discontinuation.
For the study, the researchers conducted a retrospective analysis of adults who received their first prescription for either semaglutide or liraglutide between January 1, 2018, and June 30, 2023. The primary outcome was discontinuation of GLP-1 therapy within 180 days of initiation. Among those who discontinued treatment, the investigators reviewed medical records to identify documented reasons for stopping therapy. They also assessed demographic and clinical factors associated with discontinuation.
A total of 1,374 patients were included in the analysis. Of these, 436 patients (31.7%) discontinued GLP-1 therapy within 180 days of treatment initiation.
Key findings of the study include:
- Nearly one-third (31.7%) of patients discontinued GLP-1 therapy within 180 days.
- Adverse drug reactions accounted for 26.8% of documented discontinuations, making them the most common reason for stopping treatment.
- Cost-related concerns contributed to 14.4% of discontinuations.
- Non-adherence was responsible for 11.2% of treatment discontinuations.
- Patients of Asian, Native American, or Pacific Islander race had significantly higher odds of discontinuing therapy than White patients (adjusted OR 2.51).
- Patients using GLP-1 therapy solely for overweight or obesity had a higher likelihood of discontinuation than those treated for both diabetes and overweight/obesity (adjusted OR 2.46).
The findings suggest that early GLP-1 discontinuation is common in routine practice and is driven mainly by adverse drug reactions and medication costs. Higher discontinuation rates among certain racial groups and patients using GLP-1 therapy for obesity alone also highlight potential healthcare disparities.
The researchers noted that the retrospective design and reliance on electronic health records may have led to incomplete documentation of reasons for discontinuation. They also acknowledged that the findings, derived from a single integrated healthcare system, may not be generalizable to all populations.
The researchers concluded that nearly one-third of patients discontinue GLP-1 therapy within six months, with adverse drug reactions and cost being the primary barriers. They emphasized that addressing these challenges may improve long-term treatment adherence and outcomes in patients with diabetes and obesity.
Reference:
Van Laren J, Friesleben C, Gershovich O, Helm L, Patel RJ, Delate T. Characterisation of real-world patients who discontinued a glucagon-like peptide-1 agonist. Diabetes Obes Metab. 2026;28(5):3965-3973. doi:10.1111/dom.70579
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