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Oral semaglutide lowers HbA1c levels better than sitagliptin

NEW ORLEANS — Oral semaglutide, as an add-on to metformin with or without sulfonylurea, resulted in greater HbA1c reductions after 26 weeks vs. sitagliptin, according to a poster at The Endocrine Society Annual Meeting and a study simultaneously published in JAMA.

Researchers randomly assigned 1,864 patients with type 2 diabetes uncontrolled with metformin, with or without a sulfonylurea, to receive either 3 mg, 7 mg or 14 mg of oral semaglutide daily, or 100 mg of sitagliptin daily.

The trial’s primary endpoint, mean change in HbA1c from baseline to 26 weeks, was

–0.6% with 3 mg of oral semaglutide (Novo Nordisk), –1% with 7 mg of oral semaglutide, and –1.3% with 14 mg of oral semaglutide vs. –0.8% with 100 mg of sitagliptin (Januvia, Merck) daily.

These results are “consistent with other head-to-head trials” that test glycemic control and weight reduction with GLP-1 receptor agonists over DPP-IV inhibitors, Julio Rosenstock, MD, of the Dallas Diabetes Research Center at Medical City, and colleagues wrote in JAMA.

Novo Nordisk has two new drug applications for oral semaglutide pending before the FDA.

More Healio coverage of this study can be found by clicking here. – by Janel Miller and Katie Kalvaitis

References:

Rosenstock J, et al. SAT-139. Clinical impact of oral semaglutide compared with

sitagliptin in T2D on metformin ± sulfonylurea: The Pioneer 3 trial. Presented at: The

Endocrine Society Annual Meeting; March 23-26, 2019; New Orleans.

Rosenstock J, et al. JAMA. 2019;doi:10.1001/jama.2019.2942.

Disclosures: Rosenstock reports he is an advisory board member and consultant for Boehringer Ingelheim, Eli Lilly and Company, Intarcia, Janssen, Novo Nordisk and Sanofi and has received grants from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly and Company, Genentech, GlaxoSmithKline, Intarcia, Janssen, Lexicon Pharmaceuticals, Merck, Novo Nordisk, Pfizer and Sanofi. Please see the study for all other authors’ relevant financial disclosures.