Disparities in GLP-1RA Prescription for Primary Prevention of ASCVD in Patients with T2D

Introduction and Objective: Identify disparities in GLP1RA prescription (GLP1RA-Rx) for primary prevention of Atherosclerotic Cardiovascular disease (ASCVD) in adults with T2D. Methods: Retrospective analysis of a large health system Electronic Health Record (EHR) database. Results: From June 2016-August 2023, 791,873 ambulatory encounters were included. Dialysis and pregnancy were excluded. EHR phenotyping [≥2 appropriate ICD10 codes on subsequent visits AND either abnormal diabetes defining labs or T2D medications] identified 38,435 with T2D and without ASCVD (age 61.5±9 yrs, 52% women, 48% Non Hispanic White (NHW), 37% private insurance (PI), 32% Medicare and 71% within less deprived ADI Quintiles (1-3). Cardiometabolic comorbidities included obesity 57%, HTN 78%, dyslipidemia (DL) 54%, CKD 13%, heart failure (HF) 3%, and smoking 7%. GLP1RA-Rx was low (n=11352, 29.5%) and more often in younger age (57±11 vs 62±13 yrs), women (56%), NHW (49%), PI (49%), less deprived ADI (72%), obesity (70%), DL (62% vs 51%) and CKD (15% vs 13%) vs. no GLP1RA-Rx. There was no difference in HTN, smoking or mean A1C levels. Logistic regression analysis showed women were more likely to have GLP1RA-Rx after adjustment for age, race/ethnicity, socioeconomics, and comorbidities. Conclusion: In a large primary prevention cohort with T2D and high cardiometabolic risk, GLP1RA-Rx was low and disproportionately higher in women regardless of age, socioeconomic or ASCVD risk factors. Disclosure: A.R. Sadhu: Advisory Panel; Abbott Diagnostics. E. Avenatti: None. R. Gullapelli: None. K. Nasir: Research Support; Novartis Pharmaceuticals Corporation, ESPERION Therapeutics, Inc. Advisory Panel; Amgen Inc, Merck Sharp & Dohme Corp, ER Squib & Sons. Research Support; National Institutes of Health, PCORI. S.R. Kashyap: Research Support; Fractyl Health, Inc. Advisory Panel; GI Dynamics. Research Support; Janssen Pharmaceuticals, Inc, Novartis Pharmaceuticals Corporation.