Overview
- In a BMJ Medicine study of more than 333,000 U.S. veterans, continuous GLP-1 use was associated with an 18% lower risk of major cardiovascular events than treatment with sulfonylureas.
- Interrupting therapy for six months erased much of the protection, one year off was linked to a 14% higher risk, and two years off to a 22% higher risk compared with continuous use.
- Restarting after a break restored only partial benefit, with risk reductions around 12% versus 18% among those who never paused.
- Treatment disruptions were common as 26% stopped and 23% had interruptions of at least six months, often due to cost, side effects or shortages.
- Separate Cleveland Clinic data on 7,938 people who discontinued semaglutide or tirzepatide found small average weight changes at one year, likely reflecting frequent reinitiation (20%), switches to other medications (27%) or lifestyle care (14%), while experts note the VA findings come from an observational, predominantly male cohort.