Semaglutide users experienced a 0.56% lower average at two-year follow-up compared to DPP-4i users.
The reduction in HbA1c from baseline was 0.61% greater for semaglutide compared to DPP-4i.
After adjustments, the odds of achieving an HbA1c level below 7% were 2.16 times greater for semaglutide users.
Semaglutide was associated with a 1.03 kg/m² greater reduction in compared to DPP-4i.
Users of semaglutide had 2.27 times greater odds of reducing their BMI category than those on DPP-4i.
Semaglutide users were less likely to require additional glucose-lowering treatments or insulin compared to DPP-4i users.
Simplified
INTRODUCTION: Long-term effectiveness and of glucose-lowering medications are important considerations in managing type 2 diabetes (T2D). This study aimed to compare durability of treatment efficacy of once-weekly (OW) semaglutide for T2D with that of the dipeptidyl peptidase 4 inhibitor (DPP-4i) class.
METHODS: This observational cohort study used 2017-2022 data from the OptumClinformaticsData Mart to compare long-term clinical outcomes associated with semaglutide or DPP-4i in US adults with T2D. The primary outcomes were at 2-year follow-up, change in HbA1c from baseline, and the odds of achieving HbA1c targets. at 2-year follow-up, change in BMI from baseline, odds of reducing BMI category, and the need for treatment augmentation were exploratory outcomes. Bivariate and multivariate analyses were conducted using inverse probability of treatment weighting (IPTW) weighted descriptive statistics. ® ®
RESULTS: Weighted HbA1c and BMI cohorts included 865 and 642 semaglutide users and 779 and 537 DPP-4i users, respectively. In the weighted HbA1c cohort, semaglutide and DPP-4i users had an average age of 60 years and similar baseline characteristics including HbA1c level and comorbidity status. Two-year follow-up HbA1c with semaglutide was 0.56% lower than with DPP-4i; reduction in HbA1c from baseline was 0.61% greater. Odds of achieving HbA1c level < 7% were 2.16 times greater after covariate adjustment (all, p < 0.001). Semaglutide was associated with 1.03 kg/mgreater reduction in BMI and 2.27 times greater odds of reducing BMI category vs DPP-4i (p < 0.001). Semaglutide users were less likely to add new glucose-lowering treatment (hazard ratio [HR] 0.57; p < 0.001) or initiate insulin (HR 0.49; p < 0.001) vs DPP-4i users. 2
CONCLUSION: Compared with DPP-4i, semaglutide was associated with lower follow-up HbA1c and BMI, greater reduction in HbA1c and BMI from baseline, and reduced likelihood of requiring treatment augmentation or insulin initiation to manage T2D in US adults, suggesting better durability of semaglutide vs DPP-4i. INFOGRAPHIC.
Key numbers
0.56%
Reduction
Two-year follow-up levels in semaglutide users vs DPP-4i users.
1.03 kg/m²
Reduction
Change in from baseline to follow-up for semaglutide users vs DPP-4i users.
2.16×
Higher Odds of Target Achievement
Odds of achieving < 7% for semaglutide users vs DPP-4i users.
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Xi Tan, Yuanjie Liang, and Cory Gamble are employees of Novo Nordisk Inc. Aaron King is an employee of Baptist Medical Network MedFirst Primary Care–Quarry, and he serves as the consultant/speaker for Abbott, Astellas, Dexcom, Eli Lilly, Mannkind, and Novo Nordisk Inc.
