A new fracture-risk finding is complicating the bone-safety picture for GLP-1s, alongside fresh data on hair loss, sick leave and adherence.
Here are six recent findings to know:
- GLP-1 receptor agonists were linked to a 21% lower three-year risk of fragility fracture compared with DPP-4 inhibitors among adults with type 2 diabetes, according to a study published July 24 in JAMA Network Open. The trial emulation used data on 133,606 matched patients ages 50 to 90 and found the largest risk reductions for vertebral and hip or femur fractures. The protective association held only among patients with diabetes; GLP-1 use was tied to a higher fracture risk among those without diabetes.
- GLP-1 receptor agonists carry a higher risk of hair loss than other diabetes medications, a recent study suggests. Researchers compared adults with type 2 diabetes who started GLP-1s against those who started other diabetes drugs and found a 37% higher risk of alopecia compared with SGLT-2 inhibitors and a 68% higher risk compared with DPP-4 inhibitors. The increased risk was concentrated in non-scarring alopecia, a form of hair loss in which follicles remain intact and hair can regrow, which researchers tied to rapid weight loss and related nutrient deficiencies.
- GLP-1 use has overtaken bariatric surgery as the dominant obesity treatment for adolescents and young adults. Research tracking 204,148 patients ages 13 to 25 found exclusive GLP-1 use climbed from 88.2% to 96.1% between 2022 and 2026, while bariatric surgery completion fell from 11.6% to 3.7% over the same period.
- GLP-1s are linked to a 17.3% drop in long-term sickness leave over four years, according to research comparing 7,011 early Ozempic initiators against a matched group who started treatment four years later. Researchers tied the decline to improvements in cardiometabolic health, translating to combined employer and public fiscal savings of about $866 per employed patient per year, though the study found no significant effect on employment or total income.
- CVS Health CEO David Joyner said the economics still don’t support broad employer investment in GLP-1s, telling the Washington Post that evidence hasn’t yet shown today’s prices generate enough downstream savings to justify the cost. His comments follow CVS Caremark’s back-and-forth on preferred GLP-1 formulary status amid coverage-denial lawsuits, and come as other payers, including Cigna, have scaled back GLP-1 coverage for weight loss even as some cost-growth data suggest long-term adherence may temper spending.
- Novo Nordisk has agreed to evaluate a semaglutide implant developed by Vivani Medical aimed at improving GLP-1 adherence, which lags for more than half of patients within the first year. The implant would be used as a maintenance option after patients reach a stable dose on existing injections or pills, with dosing administered twice a year or eventually annually. A phase 1 safety study is expected to begin in mid-2026.
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