A85 PATTERN OF SEMAGLUTIDE PRESCRIPTION IN A REAL-WORLD PATIENT COHORT

TL;DR

This study examines how semaglutide is prescribed in a Canadian family medicine practice and finds it leads to weight loss, especially in non-diabetic patients.

Contribution

The study provides real-world Canadian data on semaglutide prescription patterns and outcomes in a family medicine setting.

Findings

Semaglutide was prescribed to 3.71% of patients, with weight loss as the main indication.

Patients without diabetes experienced greater weight loss than those with diabetes.

Family physicians became the primary prescribers of semaglutide by 2023 and 2024.

Abstract

The weight-loss effects of semaglutide has been studies in many randomized controlled trials. However, real-world data on its use is limited, particularly in the Canadian healthcare setting.

This study aims to explore the pattern of semaglutide prescription and associated outcomes in an academic family medicine practice in Canada.

We conducted a retrospective study of patients at the Sunnybrook Hospital family health team in Toronto, Ontario. Patients aged ≥18 years who were prescribed semaglutide between January 2018 and April 2024 were included. Baseline demographics and follow-up safety and efficacy measures were collected up to 16 months after semaglutide initiation.

Of the 9930 rostered patients, 368 (3.71%) were prescribed semaglutide during the study period. The average age of patients who were prescribed semaglutide was 57.7±14.1 years and 63.3% were female. The average BMI was 36.6±7.84 kg/m2 and 189 patients (51.4%) had diabetes. The indication for semaglutide prescription was weight-loss for 206 patients (56.0%), diabetes for 118 patients (32.1%), and both weight-loss and diabetes for 39 patients (10.6%). We observed that since 2018, there has been a growing number of family physicians prescribing semaglutide compared to endocrinologists. In 2023 and 2024, over 80% of all semaglutide prescribers for our patients were family physicians, and endocrinologists were in the minority. Despite being prescribed semaglutide, 20 patients (5.4%) did not initiate the medication and 66 (17.9%) discontinued it within 16 months. Reasons for discontinuation included gastrointestinal adverse effects (26/66, 39.4%), difficulty in access (30/66, 54.5%), and perceived lack of response (6/66, 9.1%).

Baseline and follow up weights were recorded for 211 patients (57.3%). Mean weight-loss was 7.36%. Mean weight-loss by 16 months was significantly greater in patients without diabetes (8.83% vs. 6.18%, p=0.003) and in females (8.30% vs. 5.90%, p=0.009), although there were more females without diabetes compared to males. The mean HbA1c at follow-up was 6.5±1.1%, which represents a significant reduction of 10.7% from baseline (p <0.001).

Our analysis of a real-world cohort of patients who used semaglutide demonstrated its wight-loss effects, particularly in those without diabetes. Understanding the demographics of patients using semaglutide and its potential effects will help inform future prescription practices.

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