Real-world evaluation of the efficacy and safety of switching from weekly dulaglutide to weekly semaglutide: The SEMA-SWITCH study

Jun 1, 2025Endocrinologia, Diabetes y Nutricion

Effectiveness and safety of changing from weekly dulaglutide to weekly semaglutide in real-life settings

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Abstract

Switching from dulaglutide to semaglutide resulted in an additional reduction in HbA1C by up to 0.54% and weight by up to 5.4 kg over 24 months.

Initial treatment with dulaglutide reduced HbA1C by 0.38% and weight by 1.3 kg over an average of 16.9 months.
After switching to semaglutide, the HbA1C reduction continued, reaching a maximum of 0.54% at 12 months.
Weight loss increased after the switch, with a maximum reduction of 5.4 kg observed at 18 months.
The frequency of adverse effects remained similar after switching to semaglutide compared to dulaglutide.

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INTRODUCTION: Dulaglutide and semaglutide are once-weekly administered GLP-1 receptor agonists (GLP-1 RAs) indicated for the treatment of hyperglycemia in individuals with type 2 diabetes mellitus (T2DM) and obesity (BMI ≥ 30 kg/m). 2

OBJECTIVE: To evaluate the efficacy and safety of switching from subcutaneous (SC) dulaglutide to SC semaglutide, in real-world conditions.

MATERIALS AND METHODS: A total of 123 individuals with T2DM on SC dulaglutide, either as monotherapy or with other antihyperglycemic drugs, who switched to SC semaglutide were included. This switch was motivated by insufficient reduction in glycated hemoglobin (HbA1C), the need for greater weight loss, or gastrointestinal intolerance associated with dulaglutide. Changes with semaglutide in HbA1C and weight at 6, 12, 18, and 24 mo, as well as any changes in associated adverse effects. Data are expressed as mean ± standard deviation.

RESULTS: Previous treatment with dulaglutide (duration 16.9 ± 13.8 mo) reduced HbA1c by 0.38% (p = 0.003 vs. baseline) and weight by -1.3 kg (p = 0.003 vs. baseline). After switching to semaglutide, an additional reduction in HbA1C levels was observed at 6, 12, 18, and 24 mo (-0.43%, p = 0.000; -0.54%, p = 0.000; -0.38%, p = 0.021; -0.12%, p = 0.622, respectively) and in weight at 6, 12, 18, and 24 mo (-2.7 kg, p = 0.000; -3.7 kg, p = 0.000; -5.4 kg, p = 0.001; -4.2 kg, p = 0.000, respectively) With no significant differences in the frequency of adverse effects after switching to semaglutide.

CONCLUSIONS: In real-world conditions, switching dulaglutide to semaglutide in obese patients with T2DM is associated with an additional reduction in HbA1C and weight, without notable changes in the frequency of adverse effects.

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Real-world evaluation of the efficacy and safety of switching from weekly dulaglutide to weekly semaglutide: The SEMA-SWITCH study

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