Comparative efficacy, safety, and cardiovascular outcomes with once-weekly subcutaneous semaglutide in the treatment of type 2 diabetes: Insights from the SUSTAIN 1–7 trials

Jan 8, 2019Diabetes & metabolism

Effectiveness, safety, and heart health with once-weekly semaglutide injections for type 2 diabetes from SUSTAIN 1-7 trials

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Abstract

In a clinical trial involving over 8000 patients, semaglutide significantly decreased the occurrence of cardiovascular events compared with placebo.

Semaglutide is a glucagon-like peptide-1 receptor agonist approved for treating type 2 diabetes with a once-weekly injection.
It works by stimulating insulin release and inhibiting glucagon secretion, leading to lower blood glucose levels.
Semaglutide also reduces appetite and food cravings, contributing to weight loss.
In trials, semaglutide consistently showed superior glycemic control and sustained weight loss compared to other treatments.
The cardiovascular safety profile demonstrated a hazard ratio of 0.74 for cardiovascular events in patients at high risk, indicating a significant reduction compared to standard care.

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In individuals with type 2 diabetes, glycaemic control and cardiovascular risk factor management reduces the likelihood of late-stage diabetic complications. Guidelines recommend treatment goals targeting HbA, body weight, blood pressure, and low-density lipoprotein cholesterol. Development of new treatments for type 2 diabetes requires an understanding of their mechanism and efficacy, as well as their relative effects compared to other treatment choices, plus demonstration of cardiovascular safety. Subcutaneous semaglutide is a glucagon-like peptide-1 receptor agonist currently approved in several countries for once-weekly treatment of type 2 diabetes. Semaglutide works via the incretin pathway, stimulating insulin and inhibiting glucagon secretion from the pancreatic islets, leading to lower blood glucose levels. Semaglutide also decreases energy intake by reducing appetite and food cravings, and lowering relative preference for fatty, energy-dense foods. Semaglutide was evaluated in the SUSTAIN clinical trial programme in over 8000 patients across the spectrum of type 2 diabetes. This review details the efficacy and safety profile of semaglutide in the SUSTAIN 1-5 and 7 trials, and its cardiovascular safety profile in the SUSTAIN 6 trial. Semaglutide consistently demonstrated superior and sustained glycemic control and weight loss vs. all comparators evaluated. In SUSTAIN 6, involving patients at high risk of cardiovascular disease, semaglutide significantly decreased the occurrence of cardiovascular events compared with placebo/standard of care (hazard ratio 0.74, P < 0.001 for non-inferiority). Through a comprehensive phase 3 clinical trial program, we have a detailed understanding of semaglutide's efficacy, safety, cardiovascular effects and comparative role in the treatment of type 2 diabetes. 1c

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Comparative efficacy, safety, and cardiovascular outcomes with once-weekly subcutaneous semaglutide in the treatment of type 2 diabetes: Insights from the SUSTAIN 1–7 trials

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