Once-weekly semaglutide lowers HbA1c, body weight after 1 year in real-world data
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Adults with type 2 diabetes had reductions in both body weight and HbA1c after 1 year on semaglutide similar to the reductions observed in clinical studies, according to data from a real-world study published in Diabetic Medicine.
“While the once-weekly subcutaneous GLP-1 receptor agonist semaglutide has been extensively studied in randomized clinical trials, only few reports on its efficacy in real-world clinical practice have been published,” Katrine Bagge Hansen, MD, PhD, chief physician at Steno Diabetes Center in Copenhagen, Denmark, and colleagues wrote. “In the present real-world retrospective observational cohort study, we found that treatment with once-weekly subcutaneous semaglutide added to a broad range of antidiabetic medications, resulted in clinically relevant reductions in both HbA1c and body weight in persons with type 2 diabetes; comparable to what have been observed in randomized clinical trials.”
Researchers conducted a retrospective observational cohort study of 119 adults with type 2 diabetes who started once-weekly semaglutide (Ozempic, Novo Nordisk) between August and October 2018. Of the participants, 37 did not use a GLP-1 receptor agonist in the previous 12 months, and 82 were previous non-semaglutide GLP-1 receptor agonist users. For most participants who did not previously use a GLP-1 receptor agonist, semaglutide was initiated at a 0.25 mg dose weekly, increasing to 0.5 mg after 4 weeks. For previous GLP-1 receptor agonist users, semaglutide started with either a 0.25 mg or 0.5 mg weekly dose. Both groups had the dose increase 1 mg weekly after 4 to 8 weeks if their glycemic target was not reached and adverse effects did not hinder it. Data were collected at baseline and 3, 6 and 12 months after initiation. Outcomes included change in HbA1c, body weight, blood pressure and insulin dose.
At baseline, participants were treated with a broad range of diabetes medications, and 77% had one or more diabetes complications. After 12 months, 69 participants were receiving a 1 mg weekly dose of semaglutide, including 17 who had not previously used a GLP-1 receptor agonist and 52 current GLP-1 receptor agonist users.
After 12 months, participants had a mean 2.7% decrease in HbA1c compared with baseline (P < .001). There was no significant difference between those who were GLP-1 receptor agonist naive and those who previously took a GLP-1 receptor agonist. Participants had a 3.5 kg decrease in body weight (P < .001) with no significant difference between GLP-1 receptor agonist-naive adults and those with previous GLP-1 receptor agonist use.
In 57 participants using insulin, there was a decline in mean total insulin doses of 6.6 U after 12 months (P = .01). Compared with baseline, semaglutide did not result in change to either systolic or diastolic BP at 12 months.
Gastrointestinal adverse effects were reported by 22 participants after 3 months of semaglutide. Three adults reported adverse effects after 6 months and 11 adults experienced adverse effects at 12 months. Only one participant reported adverse effects during the entire study period.
“The proportion of persons experiencing side effects in our cohort was lower than reported from the SUSTAIN 1-7 studies, in which 27% to 44% of persons reported adverse events,” the researchers wrote.
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