Semaglutide Add-on Therapy Improves Glycemic Control

Semaglutide (OZEMPIC) taken weekly as an add-on therapy to sodium-glucose cotransporter-2 (SGLT-2) inhibitors was effective at enhancing glycemic control and increasing weight loss in patients with type 2 diabetes.

The SUSTAIN-9 study, published in the May 1 issue of The Lancet Diabetes and Endocrinology, was a double-blind parallel-group study conducted across 61 centers in six countries. The study population included 302 patients with type 2 diabetes (and HBA1c levels between 7.0% and 10.0%) were randomly assigned (1:1) to receive semaglutide 1.0 mg or volume-matched placebo once per week for 30 weeks, in addition to existing antidiabetic and SGLT-2 medications the patients were taking. The primary outcomes of interest was a change in HBA1c levels from baseline to week 30, with a confirmatory secondary outcome of change in body weight from baseline to week 30. The authors also assessed safety.

According to the study results, 294 patients completed the trial and 267 complete the treatment (88.4%). Additional antidiabetic medications included metformin (n=216) and sulphonylurea (n=39). The results indicated that patients taking the semaglutide add-on to their usual therapy saw greater reductions in HBA1c levels (estimated treatment difference=1.42% [95% CI −1.61 to −1.24]; −15.55 mmol/mol [–17.54 to −13.56]) and body weight (−3.81 kg; –4.70 to −2.93)compared to those taking placebo (P<0.0001 for both). A total of 356 adverse events were reported by 104 patients in the semaglutide group (compared to 247 adverse events reported by 91 patients in the placebo group). The most commonly reported adverse events were gastrointestinal in nature (56 patients in the semaglutide group vs. 20 in the placebo group). Serious adverse events were low in both groups (seven in the semaglutide group and six in the placebo group). No deaths were reported during the trial.

“Adding semaglutide to SGLT-2 inhibitor therapy significantly improves glycemic control and reduces body weight in patients with inadequately controlled type 2 diabetes, and is generally well tolerated,” the researchers concluded.

The study was funded by Novo Nordisk.

Encouraging results but still some longer term uncertainties re SGLT2 class. Shame that 2 months on Vision software still limits prescribing choices.https://t.co/tkeaSrPwQj …

— Julian Sweetman (@sweetman_julian) March 15, 2019

Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial https://t.co/cQQQqJoJf4

— Christian Kirchhoff (@christian_dkka) March 10, 2019

New @TheLancetEndo #SUSTAIN9: adding #Semaglutide to #SGLT2i therapy resulted in improvements in both HbA1c (-1·42%) & bodyweight (-3.81kg) compared with placebo in people with #T2D @johnrpetrie @cjs80 @drkashali @NRSDiabetes https://t.co/07ogq2UmEH … pic.twitter.com/KuyZtscHB5

— James Boyle (@drjamesboyle) March 2, 2019

https://t.co/0QLmm8rG0L Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial. Tras METF+SGLT2 Semaglutide consigue ⬇️1,42% A1c (A1 basal:8,0%) y ⬇️3,81kg (Peso basal:91,7kg) vs placebo @novonordisk pic.twitter.com/XynRo6oKEk

— Cristobal Morales (@CristobMorales) March 5, 2019