Findings from a post hoc analysis of the phase 3a SUSTAIN 2-4 trials demonstrated greater mean reductions in HbA1c and body weight with once-weekly semaglutide treatment compared to sitagliptin, exenatide extended release (ER) and insulin glargine U100 in adults with type 2 diabetes, across multiple background oral antidiabetic (OAD) treatment categories. The results were presented today at the Endocrine Society’s 99th Annual Meeting and Expo (ENDO 2017) in Orlando, FL, US.
“Type 2 diabetes is a complex disease, and as a result many patients are not reaching their targets on current oral antidiabetic therapy,” said Vanita Aroda, SUSTAIN 4 investigator and physician investigator at the MedStar Health Research Institute, Hyattsville, MD, US. “Results from this post hoc analysis show that once-weekly semaglutide consistently lowered blood glucose and weight in people with type 2 diabetes regardless of their current oral antidiabetic therapy.”
On a background of metformin or metformin plus sulfonylurea, treatment with semaglutide (0.5 mg/1.0 mg) significantly reduced HbA1c compared with all treatment comparators (p<0.05). In the smaller groups of people on a background of less commonly used OADs (thiazolidinedione [TZD] alone, or TZD in combination with metformin or sulfonylurea), semaglutide 1.0 mg significantly reduced HbA1c vs. sitagliptin (p<0.05); there was a numerically greater reduction in HbA1c with semaglutide 0.5 mg vs. sitagliptin (p=non-significant [ns]); and semaglutide 1.0 mg demonstrated a greater reduction in HbA1c vs. exenatide ER, although statistical significance was not reached.
Furthermore, people treated with semaglutide 1.0 mg achieved significantly greater reductions in mean body weight across all OAD categories vs. all comparators (p<0.05). People treated with semaglutide 0.5 mg on a background of metformin or metformin plus sulfonylurea achieved significantly greater reductions in mean body weight vs. sitagliptin, exenatide ER and insulin glargine U100 (p<0.0001). The reductions seen across the background treatment category of OADs less commonly used in this post hoc analysis did not reach statistical significance.
The rate of severe or blood glucose-confirmed symptomatic hypoglycaemia for people treated with semaglutide (0.5 mg/1.0 mg) was comparable with sitagliptin and exenatide ER and lower compared with insulin glargine U100, irrespective of background OAD treatment.
Semaglutide was well tolerated, with a similar safety profile to that of other GLP-1 receptor agonists.