Differences in Prescribing Rates of Glucagon-Like Peptide-1 Receptor Agonists Between Spinal Cord Injured and Non-Spinal Cord Injured Individuals: A Retrospective Study.

BACKGROUND: While glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been effectively used for obesity management, their frequency of use has not been studied specifically in individuals with spinal cord injury (SCI). OBJECTIVES: This study aimed to determine if prescribing rates of GLP-1RAs in individuals with obesity differ between those with and without SCI. DESIGN/METHODS: This retrospective cohort study was conducted on the TriNetX, LLC platform with de-identified electronic health record data from over 60 US health care organizations. Two cohorts were analyzed for prescribing rates of GLP-1RAs within 5 years of meeting inclusion criteria. One group carried a diagnosis of obesity but not SCI while the other had obesity and SCI. Individuals with a prior history of bariatric surgery or GLP-1RA use were excluded. The 2 cohorts were balanced for age, gender, race, and type 2 diabetes mellitus. RESULTS: In persons with obesity, SCI individuals had lower prescribing rates of GLP-1RAs (odds ratio [OR] 0.67, 95% CI 0.61-0.73) compared with non-SCI individuals. No significant differences in GLP-1RA prescribing rates were noted when comparing complete SCI or incomplete SCI individuals with persons without SCI. Individuals with complete SCI also had lower odds of receiving GLP-1RA prescriptions (OR 0.71, 95% CI 0.52-0.96) compared with incomplete SCI individuals. CONCLUSION: GLP-1RA prescribing rates are significantly lower in individuals with obesity and any degree of SCI compared with non-SCI individuals. Future studies will help elucidate factors that influence prescribing patterns.