The lancet. Diabetes & endocrinology

Effectiveness and safety of once-weekly 2.0 mg versus 1.0 mg semaglutide in people with type 2 diabetes

Updated

Abstract

In a trial involving 961 participants, semaglutide 2.0 mg resulted in a mean HbA1c reduction of -2.2 percentage points compared to -1.9 percentage points with 1.0 mg.

  • Semaglutide 2.0 mg showed a statistically significant greater reduction in HbA1c compared to 1.0 mg, with an estimated treatment difference of -0.23 percentage points.
  • Participants receiving semaglutide 2.0 mg experienced an average weight loss of -6.9 kg, while those on 1.0 mg had a weight loss of -6.0 kg.
  • Gastrointestinal disorders were the most frequently reported adverse events, occurring in 34% of the 2.0 mg group and 31% of the 1.0 mg group.
  • The frequency of serious adverse events was similar between the two dosage groups, with 4% in the 2.0 mg group and 5% in the 1.0 mg group.
  • Three deaths were reported during the trial, with one in the 1.0 mg group and two in the 2.0 mg group.

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Funding

Competing interests

Declarations of interest JPF reports grants and personal fees from Novo Nordisk; grants from AstraZeneca, BMS, Janssen, Novartis, Oramed, and Pfizer; and grants and personal fees from Boehringer Ingelheim, Eli Lilly, Merck KGaA, and Sanofi. HSB reports trial fees paid to his institution by Novo Nordisk; speaking honoraria from Eli Lilly and Novo Nordisk; and trial fees paid to his institution by Amgen, AstraZeneca, Boehringer Ingelheim, Ceapro, Eli Lilly, Gilead, Janssen, Kowa Pharmaceuticals, Madrigal Pharmaceuticals, Merck KGaA, Novo Nordisk, Pfizer, Sanofi, and Tricida. IL reports grants, personal fees, and non-financial support from Novo Nordisk; grants, personal fees, and non-financial support from Novo Nordisk and Sanofi; personal fees and non-financial support from Eli Lilly, Sanofi, AstraZeneca, Boehringer Ingelheim, and Janssen; personal fees from Intercept, Intarcia, TARGETPharma, Mannkind, Valeritas, Bayer, and Zealand Pharma, grants; and non-financial support from Merck and Pfizer, and grants from Mylan. TIT reports lecture fees and advisory board membership for Boehringer Ingelheim, AstraZeneca, Novo Nordisk, Sanofi, Eli Lilly, Novartis, and MSD. NT reports consultation fees from MSD, clinical trial fees from AstraZeneca, Eli Lilly, Boehringer Ingelheim, Sanofi, and Novo Nordisk, and unrestricted grants from Eli Lilly, Boehringer Ingelheim, ELPEN, and TrigoCare. ALS, PA, and SM are full-time employees of Novo Nordisk and own shares in the company. JBB reports a grant and non-financial support from Novo Nordisk; contracted consulting fees and travel support paid to the University of North Carolina (contract between University of North Carolina and the companies) from Adocia, AstraZeneca, Eli Lilly, Fractyl, Intarcia Therapeutics, Lexicon, MannKind, Metavention, Novo Nordisk, Sanofi, Senseonics, vTv Therapeutics, and Zafgen; research contracts, largely for clinical trials, and travel support paid to the University of North Carolina (contract between University of North Carolina and the companies) from AstraZeneca, Eli Lilly, Intarcia Therapeutics, Johnson & Johnson, Lexicon, NovaTarg, Novo Nordisk, Sanofi, Theracos, Tolerion, and vTv Therapeutics; consulting fees from Cirius Therapeutics, Fortress Biotech, Moderna, Pendulum Therapeutics, and Zealand Pharma; stock or options in lieu of payments for consulting and travel support for consulting activities from Mellitus Health, Pendulum Therapeutics, PhaseBio, Praetego, and Stability Health; and grants and non-financial support from the National Institutes of Health, Juvenile Diabetes Research Foundation International, Patient Centered Outcomes Research Institute, and the American Diabetes Association. YF declares no competing interests. The authors have not been paid or received compensation for their authorship.
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