Switching to semaglutide, a GLP-1 analog, from another GLP-1 receptor agonists (such as liraglutide, dulaglutide or exenatide) resulted in a further decrease in body weight and HbA1c, in the patients with type 2 diabetes. This is the finding from a new study published in the journal Diabetes, Obesity and Metabolism.
Semaglutide is a GLP‐1 analog approved for the treatment of type 2 diabetes. Rune V. Overgaard, Department of Quantitative Clinical Pharmacology, Novo Nordisk A/SSøborg, Denmark, and colleagues conducted the study to investigate the impact of switching treatment from another GLP‐1 receptor agonist (GLP‐1RA) to semaglutide through analyses of exposure‐response models.
For the study, HbA1c and body weight time‐course models were developed using up to 30 weeks of observations from 4 trials in the semaglutide phase 3 programme. Given the recommended dosing for each GLP‐1RA, pharmacokinetic profiles were simulated based on published population pharmacokinetic models and exposure was adjusted by the relative potencies to ensure that model prediction matched the effects observed in clinical trials. After 26 weeks of simulated treatment with liraglutide, dulaglutide or exenatide extended‐release, simulated semaglutide treatment was initiated one day after the last once‐daily liraglutide dose and one week after the last once‐weekly dulaglutide or exenatide extended‐release doses.
- The potency-adjusted total effective GLP-1RA concentration increased after switching from another GLP-1RA to semaglutide and was associated with reductions ranging from ~0.3 to ~0.8 %-points for HbA1c and from ~2 to ~4% for body weight with semaglutide 1.0 mg.
- Temporary slight deteriorations in HbA1c were observed after switching to semaglutide 0.25 mg from liraglutide 1.2/1.8 mg or dulaglutide 1.5 mg.
“Our findings suggest that switching to semaglutide from liraglutide, dulaglutide or exenatide extended-release results in further reductions in HbA1c and body weight. Initial slight deterioration in outcome values when switching to semaglutide 0.25 mg could be avoided by initiating semaglutide treatment at a higher dose,” concluded the authors.
For more information log on to https://doi.org/10.1111/dom.13479