Evidence mapPaperPMID 41355396Full record

ArticleThe Annals of pharmacotherapy2026

Association of Baseline Comorbidities With First-Year Adherence to GLP-1 Receptor Agonists in Patients With Diabetes or Obesity: A Retrospective Cohort Study.

Ziyang Mai, John Kornak, Suzanne M Dufault, Michael W Strand, Andrew R Reikes, Jonathan H Watanabe

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Article in The Annals of pharmacotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Ziyang MaiDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
John KornakDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Suzanne M DufaultDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Michael W StrandDepartment of Clinical Pharmacy, University of California, San Francisco, CA, USA.
Andrew R ReikesDivisions of General Internal Medicine and Endocrinology, Department of Medicine, UC Irvine School of Medicine, Irvine, CA, USA.
Jonathan H WatanabeDepartment of Clinical Pharmacy, University of California, San Francisco, CA, USA.ORCID 0000-0002-2543-5305

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for diabetes and obesity. Yet, the role of comorbidities on adherence, and variability due to drug subtype or indication remains understudied.

objectiveStudy objective was to (a) evaluate association between baseline comorbidities and digestive system adverse events on first-year GLP-1 RA adherence and (b) assess how associations differ across GLP-1 RA subtypes and between patients with diabetes and obesity.

methodWe conducted a retrospective cohort study of adults with type 1 or type 2 or obesity initiating GLP-1 RAs between 2018 and 2023 using the University of California Health Data Warehouse. Primary outcome was first-year adherence association with baseline comorbidity and digestive system adverse event status. Adherence odds ratios based on exposure were estimated using regression. Analyses were stratified by indication and drug type.

resultAmong 69 049 adults who initiated a GLP-1 RAs between 2018 and 2023, 59.3% had diabetes and 74.4% had obesity. Among patients with diabetes, hypertensive disorder (OR: 1.06, 95% CI: 1.01-1.10), hyperlipidemia (OR: 1.17, 95% CI: 1.12-1.22), and chronic kidney disease (CKD) (OR: 1.14, 95% CI: 1.08-1.21) increased adherence likelihood. Among patients with obesity, hyperlipidemia (OR: 1.10, 95% CI: 1.05-1.15) and CKD (OR: 1.09, 95% CI: 1.02-1.16) were associated with increased adherence. In patients with diabetes, atherosclerotic cardiovascular disease (ASCVD) and digestive system adverse events reduced adherence likelihood (OR: 0.90, 95% CI: 0.86-0.95) and (OR: 0.94, 95% CI: 0.90-0.98), respectively. Results were similar for patients with obesity. Findings remained consistent overall in brand-specific analyses. CONCLUSION AND RELEVANCE: Comorbidities affected GLP-1 RA adherence with variation by drug and indication. Further research is needed to understand drivers of these patterns and how they may inform future strategies to support adherence.

Indexed as

Diabetes Mellitus, Type 1Diabetes Mellitus, Type 2Drug MonitoringGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsObesityAdultAgedCohort StudiesComorbidityFemaleHumansMaleMiddle AgedRetrospective StudiesGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsadherencecomorbiditydiabetesGLP-1 RAglucagon-like peptide-1 receptor agonistobesitytype 2 diabetes

Identifiers

PMID41355396
PMCPMC13332170

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.