Liraglutide vs semaglutide: Which is a better GLP-1 RA for diabetic veterans?

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) liraglutide and semaglutide are both effective at lowering haemoglobin A1c (A1c) among veterans with type 2 diabetes mellitus (T2DM), reports a recent study, which provides insights into key considerations for this population.

One hundred fifty-four T2DM patients prescribed liraglutide or semaglutide between 1 September 2019 and 30 September 2020 were enrolled in this retrospective, single-centre, cohort study. Participants between the two treatment groups were matched based on age and insulin use at baseline.

The authors assessed the difference in A1c between the most recent A1c in the study period and baseline A1c obtained prior to GLP-1 RA initiation.

Mean A1c reduction was numerically higher in patients treated with liraglutide (‒1.1 percent vs ‒0.8 percent), but this did not reach statistical significance (p=0.22). Likewise, no significant between-group difference was observed in the proportion of patients achieving A1c <7 percent, <8 percent, <9 percent, or their patient-specific A1c goal.

Patients in the semaglutide group showed higher baseline total daily doses of insulin and had numerically greater reductions in total daily dose of insulin and weight from baseline. However, the difference was not statistically significant.

In terms of adverse drug reactions, the semaglutide group reported more cases (14 vs 9) than did the liraglutide group, which led to more treatment discontinuations in the former (11 vs 8).

“GLP-1 RAs are commonly prescribed medications for patients with T2DM based on cardiovascular benefits,” the authors said.