Switching patterns of GLP-1 receptor agonists from 2018 to 2025 in the largest private healthcare network in Poland

Krzysztof Łupina1  · Artur Dziewierz2,3  · Jakub Janczura1  · Zbigniew Siudak1,4

Received: 6 March 2026 / Accepted: 26 April 2026

© The Author(s) 2026

Abstract

Aims To characterize switching among GLP-1 receptor agonists (GLP-1 RAs) in a large private-sector cohort in Poland and to quantify therapy- and patient-level associations with switching while accounting for switching opportunity and calendar-time dynamics.

Methods We conducted a retrospective analysis of GLP-1 RA prescription records from the LUX MED network (2018–2025). Switching was defined as any change in agent between consecutive prescriptions. Patients with more than one pre-scription were included (n=42,423). The primary analysis used a transition-level discrete-time hazard model in which each prescription-to-prescription interval contributed one observation, and the outcome was switching at that interval. Current-therapy contrasts were reported relative to subcutaneous semaglutide. Sensitivity analyses examined alternative temporal parameterizations and additional adjustment for elapsed time.

Results Overall, 29.7% of patients switched at least once and 14.3% switched two or more times. In the transition-level analysis, 12,620 patients contributed 27,095 transitions. After adjustment for opportunity and calendar time, liraglutide was associated with substantially lower odds of switching compared with subcutaneous semaglutide (OR, 0.02; 95% CI, 0.01–0.03), whereas oral semaglutide (OR, 1.30; 95% CI, 0.78–2.17) and dulaglutide (OR, 1.70; 95% CI, 0.95–3.04) did not differ significantly. Temporal analyses revealed peaks consistent with episodic substitution and accelerated tirzepatide uptake after market entry. The principal associations remained directionally consistent in sensitivity analyses.

Conclusions Switching among GLP-1 RAs is common and time-dependent. Time-aware modelling identified therapy-spe-cific switching patterns and pronounced temporal variation; reasons for switching remain unmeasured, and the observed associations should be interpreted as hypothesis-generating.

Keywords Glucagon-like peptide-1 receptor agonists · Tirzepatide · Treatment switching · Real-world evidence · Private healthcare · Obesity

保湿润肤类产品应用指导 专家共识（2023版）

中国医师协会皮肤科医师分会

通信作者：郝飞，Email：该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。；高兴华，Email：该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

【摘要】 应用保湿润肤类产品是保护或修护皮肤屏障、维护皮肤健康和防治皮肤病的重要手段。为规范及合理应用保湿润肤类产品，中国医师协会皮肤科医师分会组织国内有关专家，结合国内外研究现状，就保湿润肤类产品的功效、成分选择、应用指征、使用法、不良反应及注意事项等深入讨论并达成此共识。

【关键词】 皮肤；保湿润肤类产品；合理应用；皮肤屏障；专家共识

DOI：10.35541/cjd.20230133

Guidance on application of moisturizers and emollients: an expert consensus（2023）

China Dermatologist Association

Corresponding authors: Hao Fei, Email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; Gao Xinghua, Email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

【Abstract】 The application of moisturizers and emollients is an important method for protecting or repairing skin barriers, maintaining skin health, and coping with skin diseases. In order to standardize and rationalize the application of moisturizers and emollients, the China Dermatologist Association convened Chinese experts in this field to conduct sessions of in⁃depth discussions based on up⁃to⁃date Chinese and international research outcomes, and reached a consensus on the efficacy, composition selection, application indications, application methods and adverse reactions of moisturizers and emollients, as well as considerations during their use.

【Key words】

Skin; Moisturizers and emollients; Rational application; Skin barriers; Expert consensus

DOI: 10.35541/cjd.20230133

    皮肤屏障功能维持着机体内环境稳定［1］ 。遗传基因异常、生理性衰退及各种疾病等均可破坏皮肤完整性，导致屏障功能障碍，进一步影响皮肤健康乃至疾病的发生和发展［2］ 。因此，使用保湿润肤类产品成为保护和修复皮肤屏障的重要措施。为规范及合理应用保湿润肤类产品，中国医师协会皮肤科医师分会组织国内有关专家，结合国内外研究现状，就保湿润肤类产品的功效、成分选择、应用指征、使用方法、不良反应及注意事项等深入讨论并达成应用指导的专家共识。

    本共识文献检索自Medline、PubMed、Cochrane协作网、中国知网、万方医学网等数据库，关键词包括 但 不 限 于 ：moisturizer、emollient、skincare、skinbarrier、保湿润肤类产品、保湿剂、润肤剂、护肤品、皮肤屏障、天然保湿因子、特应性皮炎（atopicdermatitis，AD）、玫瑰痤疮、敏感性皮肤、经表皮失水率等，检索起始时间不限，大部分参考文献为2010年后最新发表。文中近30条重要结论均经过专家组Delphi问询法论证。

The Skin Barrier and Moisturization: Function, Disruption, and Mechanisms of Repair

Jeffrey Rajkumara Neha Chandana Peter Liob Vivian Shic

a Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA;

b Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;

c  Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AK, USA

Keywords

Skin barrier · Barrier disruption · Moisturizers

Abstract

Background: The anatomic layers of the skin are well-defined, and a functional model of the skin barrier has recently been described. Barrier disruption plays a key role in several skin conditions, and moisturization is recommended as an initial  treatment in conditions such as atopic dermatitis. This review aimed to analyze the skin barrier in the context of the function model, with a focus on the mechanisms by which moisturizers support each of the functional layers of the skin barrier to promote homeostasis and repair. Summary: The skin barrier is comprised of four interdependent layers – physical, chemical, microbiologic, and immunologic – which maintain barrier structure and function. Moisturizers target disruption affecting each of these four layers through several mechanisms and were shown to improve transepidermal water loss in several studies. Occlusives, humectants, and emollients occlude the surface of the stratum corneum (SC), draw water from the dermis into the epidermis, and assimilate into the SC, re- spectively, in order to strengthen the physical skin barrier. Acidic moisturizers bolster the chemical skin barrier by sup-porting optimal enzymatic function, increasing ceramide production, and facilitating ideal conditions for commensal microorganisms. Regular moisturization may strengthen the immunologic skin barrier by reducing permeability and subsequent allergen penetration and sensitization. Key Messages: The physical, chemical, microbiologic, and im-munologic layers of the skin barrier are each uniquely impacted in states of skin barrier disruption. Moisturizers target each of the layers of the skin barrier to maintain homeostasis and facilitate repair.

GLP-1 receptor agonists and coronary plaques regression in diabetic patients after acute coronary syndromes

Mauro Gitto1,2 · Federica Catapano1,2 · Marco Francone1,2 · Gianluca Mincione1,2 · Vincenzo Scialò1,2 ·Carlo A. Pivato1,2 · Costanza Lisi1,2 · Damiano Regazzoli1,2 · Davide Cao1,2 · Roberta Maria Fiorina1  ·Alessandra Petrelli3,4 · Loredana Bucciarelli4  · Cristian Loretelli3,4 · Gianluigi Condorelli1,2 · Paolo Fiorina3,4,5 · Giulio Stefanini1,2

Received: 4 October 2025 / Accepted: 15 October 2025 / Published online: 4 November 2025 © The Author(s) 2025

Abstract

Background Despite advances in therapeutic strategies a significant proportion of acute coronary syndrome (ACS) patients experience early coronary artery disease (CAD) progression, particularly those with diabetes.

Aim To evaluate CAD progression in diabetic patients treated with glucagon-like peptide 1 receptor agonists (GLP-1Ra) over 1 year after an ACS.

Methods Patients presenting with non–ST-elevation ACS between 2019 and 2022 were enrolled in a prospective registry and underwent serial coronary computed tomography angiography (CCTA) at baseline (after revascularization, during the index hospitalization) and at 1-year follow-up. The primary endpoint was the absolute change (1 year – baseline) in non-culprit lesion plaque burden (ΔPB) on CCTA, with the absolute change in patient percent atheroma volume (ΔPAV) as a key secondary endpoint. A comprehensive lipidomic, metabolomic, and proteomic plasma assessment was also performed in all GLP-1Ra–treated patients and four randomly selected controls.

Results Of 28 diabetic patients, 7 (25%) with 22 coronary plaques were treated with GLP-1Ra, and 21 (75%) with 65 plaques received other antidiabetic agents. In the 1-year observation frame, both ΔPB (-5.8±12.8% vs. -1.1±13.6%, p=0.041) and ΔPAV (-6.1% [-7.3, -1.8] vs. -0.7% [-2.4, 9.8], p=0.039) were significantly lower in GLP-1Ra-treated patients. Total atheroma volume also showed a numerically greater reduction in the GLP-1Ra cohort (0.7 mm³ [-2.5-8.7] vs. 25.0 mm³ [4.8–39.7]), primarily due to a decrease in plaque fibrofatty volume percentage (-2.9±10.1% vs. 1.0±6.8%, p=0.042). Lipi-domic, metabolomic, and proteomic analyses identified reductions in monoacylglycerols and triacylglycerols, increases in diacylglycerols and phosphatidylethanolamine, a shift from carbohydrate metabolism toward lipid metabolism and hormone regulation, and differential expression of proteins involved in complement activation, endothelial function, and cytoskeletal organization in GLP-1Ra–treated patients compared with controls.

Conclusions In diabetic patients with ACS, GLP-1Ra therapy was associated with a significant regression in coronary plaque burden at 1 year, supported by favorable lipidomic, metabolomic, and proteomic changes. These findings suggest a potential role for GLP-1Ra in modifying atherosclerosis progression beyond glycemic control.

Keywords GLP-1 receptor agonists · Diabetes mellitus · Coronary artery disease · Acute coronary syndrome · Plaque regression

Anxiety, social responsiveness, and grit among patients with KCNJ11- related neonatal diabetes compared to unaffected siblings

Jui M. Desai1  · Lisa R. Letourneau-Freiberg1  · Kristen E. Wroblewski2  · Megan N. Scott3  · Michael E. Msall4  · Siri Atma W. Greeley1,4

Received: 27 February 2025 / Accepted: 4 October 2025 / Published online: 27 January 2026 © The Author(s) 2026

Abstract

Aims Neonatal diabetes mellitus (NDM) occurs before 6–12 months of age and is commonly caused by activating mutations in KCNJ11 (KCNJ11-NDM) or ABCC8. Because of brain expression of these mutant ATP-dependent potassium channels, a spectrum of divergent neurodevelopmental difficulties have been described, including developmental delay, epilepsy, and neonatal diabetes (DEND). However, information on anxiety, social responsiveness, and grit is limited.

Methods Individuals with KCNJ11-NDM (N= 12) and their unaffected siblings (N=12) were recruited through the Uni-versity of Chicago Monogenic Diabetes Registry and participants or their parent/caregiver completedthe Screen for Adult/ Child Anxiety Related Disorder (SCAARED/SCARED), the Social Responsiveness Scale, Second Edition (SRS-2), and the Grit Scale.

Results Mean SRS-2 scores were significantly different between KCNJ11-NDM and sibling controls (P= <0.001 ), with 7/10 affected participants, and 0 /11 siblings, having scores suggestive of autism spectrum disorder (ASD). Differences in anxiety (P=0.69) and grit (P=0.46) were not significant when compared to sibling controls; however, 58% (7/12) of KCNJ11-NDM participants and 40% (4/10) of sibling controls had scores indicating an anxiety disorder by either self- or parent-report.

Conclusions Our results agree with previous studies suggesting significant difficulties with social functioning in KCNJ11- NDM, with 7/10 participants having scores suggestive of ASD, strongly reinforcing the need for early neurodevelopmental screening to allow for prompt support. Our report adds to the knowledge of this population in finding robust grit scores but with a high level of anxiety in both KCNJ11-NDM and unaffected siblings. Although families affected by KCNJ11-NDM may have a high risk of anxiety disorders, it is encouraging that affected and unaffected children exhibit robust self-resiliency that will help support functioning through the challenges of life. Study of additional individuals will help to clarify specific challenges, long-term outcomes, and best approaches for monitoring and support.

Keywords Diabetes mellitus · Potassium channels · Brain · Anxiety · Resilience · Genetics

A high-quality RNA-yielding protocol for laser capture microdissection of transplanted stem cell-derived Islets of Langerhans

Daniel Norman1  · Joey Lau1

Received: 22 March 2025 / Accepted: 18 January 2026 © The Author(s) 2026

Abstract

Background Laser capture microdissection (LCM) followed by RNA-sequencing is a powerful, widely applicable tool to analyze the transcriptome in regions of a tissue. Protocols for LCM of transplanted islets of Langerhans, particularly stem cell-derived islets (SC-islets) that have evaluated RNA quality, are lacking. This study demonstrates a robust protocol for LCM of SC-islets in multiple organ sites, generating high quality RNA.

Method SC-islets were transplanted to five organ sites in immunodeficient NOG-mice. Graft-containing organs were then sectioned, fixed in 75% ethanol, stained with the alcohol-based stain cresyl violet, and dehydrated before performing LCM. RNA was then extracted, and quality control was performed.

Results High RIN scores (RNA Integrity Number) were obtained from all organ sites, with the pancreas showing the most robust results, despite its known challenges due to high RNase content. Conversely, organs with small or dispersed grafts, such as the liver and omentum, exhibited lower RIN scores. This is likely due to the size of the dissected area correlating positively with RIN scores, potentially due to a more time-consuming LCM in these sites.

Conclusion Using this novel protocol, high-quality RNA from transplanted SC-islets can be obtained. Smaller and spread-out grafts pose a challenge in obtaining higher quality RNA, although possible.

Keywords Laser capture microdissection · Stem cell-derived islets · RNA quality · Transplantation · Type 1 diabetes