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Patterns of GLP-1 Receptor Agonist Initiation Compared With Other Glucose-Lowering and Anti-Obesity Therapies Among Older Adults
Brooks JD, Donahue MA, ElHassan A, Tian J, Hernandez-Diaz S, Blacker D, Estiri H, Haas JS et al.. medRxiv, 2026-10-05
Topic: Drug trials: efficacy and safety
We describe the demographic and clinical characteristics of new initiators of GLP-1RAs compared with initiators of alternative therapies, including sodium-glucose cotransporter-2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i). We used a LASSO logistic regression to identify important predictors of GLP-1RA initiation compared to other therapies. Results Of 58,754 adults aged 65 years or older with T2D, 5,095 initiated GLP-1RA, 5,483 initiated a SGLT2 inhibitor, and 1,516 initiated a DPP-4 inhibitor. Conclusion In this cohort of older adults, those with T2D who initiated GLP-1RAs were younger and had less comorbidities at baseline compared to initiators of other T2D therapies. Overweight BMI was the strongest predictor of GLP-1RAs initiation, whereas baseline HbA1c was similar across groups, suggesting that the decision to start GLP1-RA is more influenced by adiposity than glycemic control.
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APA 7th
Brooks, J. D., Donahue, M. A., ElHassan, A., Tian, J., Hernandez-Diaz, S., Blacker, D., et al. (2026). Patterns of GLP-1 Receptor Agonist Initiation Compared With Other Glucose-Lowering and Anti-Obesity Therapies Among Older Adults. medRxiv. https://doi.org/10.64898/2026.09.29.26364340
Vancouver
Brooks JD, Donahue MA, ElHassan A, Tian J, Hernandez-Diaz S, Blacker D, et al. Patterns of GLP-1 Receptor Agonist Initiation Compared With Other Glucose-Lowering and Anti-Obesity Therapies Among Older Adults. medRxiv. 2026. doi:10.64898/2026.09.29.26364340.
BibTeX
@article{brooks2026-82f57b8f,
author = {Brooks, J. D. and Donahue, M. A. and ElHassan, A. and Tian, J. and Hernandez-Diaz, S. and Blacker, D. and Estiri, H. and Haas, J. S. and others},
title = {{Patterns of GLP-1 Receptor Agonist Initiation Compared With Other Glucose-Lowering and Anti-Obesity Therapies Among Older Adults}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.09.29.26364340},
url = {https://doi.org/10.64898/2026.09.29.26364340}
}
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Key findings
- We describe the demographic and clinical characteristics of new initiators of GLP-1RAs compared with initiators of alternative therapies, including sodium-glucose cotransporter-2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i).
- We used a LASSO logistic regression to identify important predictors of GLP-1RA initiation compared to other therapies.
- Results Of 58,754 adults aged 65 years or older with T2D, 5,095 initiated GLP-1RA, 5,483 initiated a SGLT2 inhibitor, and 1,516 initiated a DPP-4 inhibitor.
- Conclusion In this cohort of older adults, those with T2D who initiated GLP-1RAs were younger and had less comorbidities at baseline compared to initiators of other T2D therapies.
- Overweight BMI was the strongest predictor of GLP-1RAs initiation, whereas baseline HbA1c was similar across groups, suggesting that the decision to start GLP1-RA is more influenced by adiposity than glycemic control.
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Study details
- Study designretrospective cohort
- Participants58,754
- Effect size17.7%; 35.0%; 47.6%
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 50 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 31 of the 62 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 7 / 12 | A retrospective cohort study, reconstructed from past records |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 4 / 4 | 58,754 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 31 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 31 of the 62 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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