Ertugliflozin, oral semaglutide produce positive results in type 2 diabetes

SAN FRANCISCO — The SGLT2 inhibitor ertugliflozin and an oral version of the GLP-1 receptor agonist semaglutide demonstrated favorable results in patients with type 2 diabetes, according to data from two American Diabetes Association Scientific Sessions and a corresponding study published in The Lancet.

Ertugliflozin

The ertuglifozin results pooled data from 10 different trials where patients with diabetes received either 5 mg or 15 mg ertugliflozin (Steglatro, Merck) plus sitagliptin (Januvia, Merck), placebo or non-ertugliflozin therapy (glimepiride or sitagliptin) for up to 104 weeks. Combined, the trials included 4,794 patients younger than 65 years and 1,709 patients older than 65 years.

Researchers found that at week 26, those aged at least 65 years who received either dose of ertugliflozin had lower HbA1C and fasting plasma glucose levels. Both age groups that received ertugliflozin experienced greater weight and systolic BP drops.

“This type of research is important, as a large fraction of the patients with type 2 diabetes are elderly, yet we have very little clinical trial data to support the use of newer antihyperglycemic medications in this population,” Richard E. Pratley, MD, medical director of AdventHealth Diabetes Institute, said in an interview.

For more Healio coverage of this study, click here.

Oral semaglutide

The semaglutide data come from two trials that together, included 1,533 adults with diabetes and other similar characteristics.

In the first, researchers randomly assigned the patients in a 1:1: ratio to receive either either 14 mg of oral semaglutide (Novo Nordisk) daily or 25 empagliflozin (Jardiance, Boehringer Ingelheim) daily for 52 weeks.

Researchers found that the semaglutide-dosed group had superior HbA1c reductions and significant weight loss at 52 weeks vs. the empagliflozin-dosed group.

In the second trial, researchers randomly assigned the patients in a 2:2:1 ratio to receive daily doses of either oral semaglutide, the injectable GLP-1 receptor agonist liraglutide (Victoza, Novo Nordisk) or placebo.

Researchers found that after 26 weeks, oral semaglutide was superior to both liraglutide and placebo in terms of weight loss and superior to placebo in regards to HbA1c reduction, but noninferior to liraglutide in regards to HbA1c reduction.

“Oral semaglutide ... has the potential to become a new treatment for type 2 diabetes,” Pratley said during a presentation.

Click here for more Healio coverage of this study. – by Janel Miller, Regina Shaffer and Jill Rollet

References:

Montanya E, et al. 54-OR.

Pratley R, et al. 1210-P.

Pratley RE, et al. 55-OR.

All presented at: American Diabetes Association 79th Scientific Sessions; June 7-11, 2019; San Francisco.

Also: Pratley R, et al. Lancet. 2019;doi:10.1016/S0140-6736(19)31271-1.

Disclosures: Merck and Pfizer funded the ertugliflozin study. Pratley reports he has received grants, speaking and consultant fees paid to his institution from AstraZeneca,

Boehringer Ingelheim, Eisai, Eli Lilly, GlaxoSmithKline, Glytec, Janssen, Lexicon, Ligand Pharmaceuticals, Merck, Mundipharma, Novo Nordisk, Pfizer, Sanofi and Takeda. Please see the study and abstracts for all other authors’ relevant financial disclosures.