Efficacy and safety of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide in Japanese patients with type 2 diabetes mellitus

Aug 5, 2024Diabetology international

Effectiveness and safety of changing from one diabetes pill to oral semaglutide in Japanese patients with type 2 diabetes

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Abstract

Mean HbA1c decreased from 7.8% to 7.0% and body weight decreased from 74.2 kg to 71.2 kg after switching to oral semaglutide over 6 months.

The decrease in HbA1c was significant, indicating improved glycemic control.
Patients with higher baseline HbA1c experienced a greater reduction in levels.
A trend was observed for weight loss in individuals with shorter disease duration.
Ninety-five percent of participants showed reductions in either HbA1c or body weight.
A stronger decrease in HbA1c was associated with a greater reduction in body weight.
Twenty percent of participants discontinued the drug, primarily due to suspected adverse effects.

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BACKGROUND: Dipeptidyl peptidase-4 inhibitors (DPP-4is) are the most widely used oral hypoglycemic drugs in Japan. However, once-daily oral semaglutide has been reported to reduce glycated hemoglobin (HbA1c) and body weight (BW) without causing significant hypoglycemia. Here, we aimed to evaluate the efficacy and safety of switching from a DPP-4i to oral semaglutide in Japanese patients with type 2 diabetes (T2D).

METHODS: We performed a single-center retrospective study of the changes in HbA1c and BW in 68 patients with T2D who were switched from a DPP-4i and took oral semaglutide for ≥ 6 months, without changes in any other oral hypoglycemic agent.

RESULTS: Mean HbA1c decreased from 7.8 to 7.0% ( < 0.001) and BW decreased from 74.2 to 71.2 kg ( < 0.001) over 6 months. The decrease in HbA1c was more pronounced in participants with high baseline HbA1c ( = - 0.542, < 0.001). There was also a trend ( = 0.236, = 0.052) toward a decrease in BW in individuals with shorter disease duration. There were reductions in either HbA1c or BW in 65 participants (95.6%). In addition, the larger the decrease in HbA1c was, the greater was the decrease in BW ( = 0.480, < 0.001). Eighteen participants (20.1%) discontinued the drug within 6 months, of whom 10 (11.6% of the total) did so because of suspected adverse effects and the discontinuation rate was the highest in older, non-obese patients. p p r p r p r p

CONCLUSIONS: Switching from a DPP-4i to oral semaglutide may be useful for Japanese patients with T2D who have inadequate glycemic or BW control. However, its utility may be limited by gastrointestinal adverse effects in certain patients.

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Efficacy and safety of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide in Japanese patients with type 2 diabetes mellitus

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