Semaglutide effective for glycemic control, body weight reduction

Adults with type 2 diabetes treated with metformin experienced greater glycemic control and lost more body weight with semaglutide compared with insulin glargine, researchers reported at the 52nd European Association for the Study of Diabetes Annual Meeting.

J. Hans DeVries, MD, PhD, of the endocrinology department at the Academic Medical Center in Amsterdam, and colleagues evaluated data from the SUSTAIN 4 trial on 1,082 insulin-naive adults (mean age, 56.5 years) with type 2 diabetes randomly assigned to subcutaneous semaglutide (Novo Nordisk) 0.5 mg or 1 mg once weekly or insulin glargine (starting dose, 10 IU) once daily for 30 weeks, added to stable metformin with or without sulfonylurea. Researchers sought to determine the safety and efficacy of each therapy, and the primary endpoint was change in HbA1c from baseline to week 30. Mean baseline HbA1c was 8.2%.

Researchers titrated insulin glargine to a pre-breakfast self-monitored plasma glucose target of 4 mmol/L to 5.5 mmol/L.

The reduction in mean HbA1c was less in the insulin glargine group (0.8%) compared with the semaglutide 0.5-mg (1.2%) and semaglutide 1-mg groups (1.6%). HbA1c of 7% or less was reached by more participants in the semaglutide groups (0.5 mg, 57.5%; 1 mg, 73.3%) compared with those in the insulin glargine group (38.1%). Similarly, HbA1c of 6.5% of less was reached by more participants in the semaglutide groups (0.5 mg, 37.3%; 1 mg, 54.2%) compared with the insulin glargine group (17.5%).

All groups had similar reductions in fasting plasma glucose and mean eight-point self-monitored plasma glucose. Body weight decreased in the semaglutide groups (0.5 mg, 3.5 kg; 1 mg, 5.2 kg) compared with an increase in the insulin glargine group (1.2 kg) from a mean baseline of 93.4 kg.

When participants completed the Diabetes Treatment Satisfaction Questionnaire, increases in points were similar across all treatment groups.

Adverse events occurred in 69.9% of the semaglutide 0.5-mg group, 73.3% of the semaglutide 1-mg group and 65.3% of the insulin glargine group with serious adverse events reported in 6.1%, 4.7% and 5%, respectively. Discontinuation of treatment because of adverse events occurred in 5.5% of the semaglutide 0.5-mg group, 7.5% of the semaglutide 1-mg group and 1.1% of the insulin glargine group.

“Semaglutide achieves superior glycemic control compared with insulin glargine,” DeVries said during his presentation. “The proportion of people experiencing severe hypoglycemia was significantly lower with semaglutide compared with insulin glargine. Semaglutide resulted in body weight loss, whereas insulin glargine was associated with a slight increase in body weight. Overall, semaglutide was well tolerated as expected and similar to what we see with other [glucagon-like peptide-1] receptor agonists.” – by Amber Cox

Reference:

DeVries JH, et al. OP 148. Presented at: 52nd EASD Annual Meeting; Sept. 12-16, 2016; Munich.

Disclosure: DeVries reports various financial ties with Abbott, Becton Dickinson, Dexcom, Eli Lilly, Johnson & Johnson, Medtronic, Merck Sharp and Dohme, Novo Nordisk, Roche Diagnostics and Senseonics.