Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10)

Sep 21, 2019Diabetes & metabolism

Effectiveness and safety of weekly semaglutide 1.0mg versus daily liraglutide 1.2mg added to oral diabetes drugs in people with type 2 diabetes

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Abstract

Mean HbA1c decreased by 1.7% with semaglutide compared to 1.0% with liraglutide.

Semaglutide resulted in a greater reduction in HbA1c from a baseline of 8.2% compared to liraglutide.
Mean body weight decreased by 5.8kg with semaglutide and 1.9kg with liraglutide from a baseline of 96.9kg.
A higher proportion of subjects achieved glycemic targets of <7.0% and weight loss of ≥5% with semaglutide compared to liraglutide.
Both treatments had similar safety profiles, though semaglutide was associated with more frequent gastrointestinal disorders.
Higher rates of adverse events leading to treatment discontinuation were reported with semaglutide compared to liraglutide.

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AIMS: SUSTAIN 10 compared the efficacy and safety of the anticipated most frequent semaglutide dose (1.0mg) with the current most frequently prescribed liraglutide dose in Europe (1.2mg), reflecting clinical practice.

METHODS: In this phase 3b, open-label trial, 577 adults with type 2 diabetes (HbA7.0-11.0%) on 1-3 oral antidiabetic drugs were randomized 1:1 to subcutaneous once-weekly semaglutide 1.0mg or subcutaneous once-daily liraglutide 1.2mg. Primary and confirmatory secondary endpoints were changes in HbAand body weight from baseline to week 30, respectively. 1c1c

RESULTS: Mean HbA(baseline 8.2%) decreased by 1.7% with semaglutide and 1.0% with liraglutide (estimated treatment difference [ETD] -0.69%; 95% confidence interval [CI] -0.82 to -0.56, P<0.0001). Mean body weight (baseline 96.9kg) decreased by 5.8kg with semaglutide and 1.9kg with liraglutide (ETD -3.83kg; 95% CI -4.57 to -3.09, P<0.0001). The proportions of subjects achieving glycaemic targets of<7.0% and=6.5%, weight loss of=5% and=10%, and a composite endpoint of HbA<7.0% without severe or blood glucose-confirmed symptomatic hypoglycaemia and no weight gain were greater with semaglutide vs liraglutide (all P<0.0001). Both treatments had similar safety profiles, except for more frequent gastrointestinal disorders (the most common adverse events [AEs]) and AEs leading to premature treatment discontinuation with semaglutide vs liraglutide (43.9% vs 38.3% and 11.4% vs 6.6%, respectively). 1c1c

CONCLUSION: Semaglutide was superior to liraglutide in reducing HbAand body weight. Safety profiles were generally similar, except for higher rates of gastrointestinal AEs with semaglutide vs liraglutide. 1c

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Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10)

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