Type 2 diabetes: Semaglutide pill works just as well as injectable

22 Jul 2023 bởiJairia Dela Cruz
Type 2 diabetes: Semaglutide pill works just as well as injectable

Treatment with either oral or subcutaneous semaglutide yields favourable outcomes for patients with type 2 diabetes (T2D), according to real-world data.

Over 12 months of follow-up, use of either semaglutide formulations led to significant reductions in HbA1c, weight, and body mass index (BMI), the investigators reported.

RELATE–Oral Semaglutide

In RELATE–Oral Semaglutide, mean HbA1c fell from 8.8 percent at baseline to 7.8 percent at month 12 (p<0.001), with 32.4 percent of the participants achieving HbA1c <7.0 percent. [ADA 2023, abstract 86-LB]

Mean BMI was 34.1 kg/m2 at month 12, decreasing from 35.2 kg/m2 at baseline (p<0.001). Notably, the proportion of patients with BMI ≥40.0 kg/m2 dropped from 25.6 percent to 20.1 percent, while the proportion of those with BMI ≥30.0 kg/m2 dropped from 75.6 percent to 70.4 percent.

Finally, a mean of 3.5 kg in weight was shed, from 102.4 kg at baseline to 98.9 kg at month 12 (p<0.001). A total of 33.4 percent and 11.1 percent of participants achieved a ≥5-percent and ≥10-percent reduction in weight, respectively.

RELATE-OW Injectable Semaglutide

Likewise, participants in RELATE-OW Injectable Semaglutide had similar improvements. Mean HbA1c dropped from 8.9 percent to 7.6 percent (p<0.001), with 40.2 percent of the participants achieving HbA1c <7.0 percent over 12 months of follow-up. [ADA 2023, abstract 87-LB]

Mean BMI decreased by 1.5 kg/m2, from 36.5 kg/m2 at baseline to 35.0 kg/m2 at month 12 (p<0.001). The proportion of patients with BMI ≥40.0 kg/m2 and BMI ≥30.0 kg/m2 fell from 29.2 percent to 24.4 percent and from 81.1 percent to 73.6 percent, respectively.

Finally, mean weight improved by 4.1 kg, from 106.3 kg at baseline to 102.2 kg at month 12 (p<0.001). Weight decreased by ≥5 percent and ≥10 percent for 37.9 percent and 13.3 percent of the participants, respectively.

For the two retrospective cohort studies, researchers used linked data from IQVIA’s Longitudinal Prescription Claims, Professional Fee Claims, and Ambulatory Electronic Medical Records in the US. Medical records of adults with T2D and HbA1c ≥7 percent who initiated treatment with either the oral semaglutide formulation or the once-weekly subcutaneous formulation. Pre- and postindex (12 months) HbA1c and weight-related outcomes were analysed.

RELATE–Oral Semaglutide included 398 patients, while RELATE-OW Injectable Semaglutide involved 1,926 patients.

Improved adherence

Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA) and is the only one in its drug class that is offered in both an injectable and an oral formulation. Once-weekly subcutaneous semaglutide was approved by the US Food and Drug Administration in December 2017 and by the European Medicines Agency in February 2018, whereas once-daily oral semaglutide was approved in the US in September 2019 and in Europe in April 2020. [Endocrinol 2019;7:500-502; https://tinyurl.com/2gpdt76a; https://tinyurl.com/2k4wc8se; https://tinyurl.com/2jzobk77; https://tinyurl.com/2egg8f32]

The oral formulation is said to be more convenient to some patients, especially those who are unable to tolerate injections, have needle phobia, are unable to self-administer, or have no carer support. As such, oral semaglutide may improve acceptance of and adherence with GLP-1RA therapy, as well as provide an additional option to help increase glycaemic target achievement. [Endocrinol 2019;7:500-502]