New Treatment Improves Glycemic Control and Weight Loss

Semaglutide may be an effective add-on treatment for improving glycemic control and weight loss in patients with type 2 diabetes, according to the results of a new study.

The phase 3, randomized, double-blind, active-controlled multinational trial (SUSTAIN 2) included 1225 patients over 18 years of age with type 2 diabetes and insufficient glycemic control despite treatment with metformin, thiazolidinediones, or both. For 56 weeks, 409 patients were randomly assigned to receive 5 mg subcutaneous dose of semaglutide once a week and a daily oral placebo, 409 patients received 1 mg subcutaneous dose of semaglutide once a week and a daily oral placebo, and 407 patients received 100 mg daily oral dose of sitagliptin and subcutaneous placebo once a week.
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Changes in HbA_1c and bodyweight from baseline to 56 weeks were assessed as the primary and secondary endpoints, respectively. In addition, adverse events and hypoglycemic episodes were documented to determine the safety of semaglutide.

At 56 weeks, the mean baseline HBA_1c (8.1%) was reduced by 1.3% in patients taking 5 mg of semaglutide, 1.6% in patients taking 1 mg of semaglutide, and 0.5% in patients taking sitagliptin.

The mean baseline bodyweight (89.5 kg) and was reduced by 4.3 kg in patients taking 0.5 mg of semaglutide, 6.1 kg in patients taking 1 mg of semaglutide, and 1.9 kg in patients taking sitagliptin at 56 weeks.

A total of 33 patients (8%) taking 0.5 mg of semaglutide, 39 patients (10%) taking 1 mg of semaglutide, and 12 patients (3%) taking sitagliptin discontinued treatment due to adverse events. The most frequent adverse events reported by patients were nausea and diarrhea.

Hypoglycemia occurred in 7 patients (2%) taking 5 mg of semaglutide, 2 patients (less than 1%) taking 1 mg of semaglutide, and 5 patients (1%) taking sitagliptin.

In addition, 6 fatal events occurred, but none were considered to be likely associated with any of the treatments.

“Once-weekly semaglutide was superior to sitagliptin at improving glycaemic control and reducing bodyweight in participants with type 2 diabetes on metformin, thiazolidinediones, or both, and had a similar safety profile to that of other (glucagon-like peptide-1) receptor agonists,” the researchers concluded. “Semaglutide seems to be an effective add-on treatment option for this patient population.”

—Melissa Weiss

Reference:

Ahrén B, Masmiquel L, Kumar H, et al. Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): a 56-week, double-blind, phase 3a, randomised trial [published online April 3, 2017]. Lancet Diabetes Endocrinol. dx.doi.org/10.1016/S2213-8587(17)30092-X.