JAMA cardiology

Oral Semaglutide and Changes in Heart Risk Factors in High-Risk Type 2 Diabetes

Updated

Abstract

Oral semaglutide is associated with early and sustained improvements in multiple atherosclerotic cardiovascular disease risk factors in individuals with type 2 diabetes.

  • Participants receiving oral semaglutide showed a reduction in glycated hemoglobin by 0.87 percentage points after 13 weeks compared to placebo.
  • Body weight decreased by 2.54% in the oral semaglutide group at the same time point.
  • Systolic blood pressure decreased by 3.84 mm Hg and pulse pressure by 3.81 mm Hg with oral semaglutide compared to placebo.
  • Levels of high-sensitivity C-reactive protein decreased by 18.08% and total cholesterol by 7.00% following treatment with oral semaglutide.
  • No significant differences were found between oral semaglutide and placebo for low-density lipoprotein cholesterol or diastolic blood pressure.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr Mulvagh reported personal fees from Novo Nordisk during the conduct of the study and personal fees from Merck outside the submitted work. Dr Inzucchi reported personal fees from Novo Nordisk during the conduct of the study and personal fees from AstraZeneca, Bayer, Boehringer Ingelheim, and Corcept Therapeutics outside the submitted work. Dr Marx reported steering committee fees from Novo Nordisk during the conduct of the study and grants paid to university hospital from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Lilly, Merck Sharp & Dohme (MSD), Novo Nordisk, and Sanofi-Aventis outside the submitted work. Dr Poulter reported speaker fees from Novo Nordisk, Servier, and Takeda; advisory board activities for AstraZeneca and Novo Nordisk; and research grants for his research group relating to type 2 diabetes from the British Heart Foundation, Diabetes UK, Julius Clinical, and the UK National Institute for Health and Care Research (NIHR) Efficacy and Mechanism Evaluation program. Dr Deanfield reported receiving continuing medical education honoraria and/or consulting fees from Aegerion, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Merck, Novartis, Novo Nordisk, Pfizer, Sanofi, and Takeda; grants from Aegerion, Alzheimer’s Research UK, the British Heart Foundation, Colgate, the Medical Research Council (UK), MSD, NIHR, Pfizer, Public Health England, and Roche; and advisory agreements with Caristo Diagnostics, eMed Healthcare, Floe Oral Care Ltd, Friede-Springer Cardiovascular Prevention Center, iOWNA, PMI Harm Reduction Group, and Smarter Cardiovascular Outcomes By Research And Education Ltd (SCORE) outside the submitted work. Dr Pop-Busui reported personal fees from Novo Nordisk during the conduct of the study; grants from Bayer, Lexicon Pharma, and Novo Nordisk; and personal fees from Averitas Pharma, Bayer, Biogen, Lexicon Pharma, Nevro, Roche Diagnostic, Vertex, and Viatris outside the submitted work. Dr Emerson reported steering committee fees from Novo Nordisk during the conduct of the study and personal fees from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, Novartis, Roche, Sanofi, and Vertex outside the submitted work. Dr Mann reported personal fees from Novo Nordisk during the conduct of the study and personal fees from AstraZeneca, Bayer, Icon, IQVIA, Sanofi, and WCG outside the submitted work. Drs Engelmann, Hovingh, and Davicevic-Elez and Mr Jeppesen reported being employees of and shareholders in Novo Nordisk A/S during the conduct of the study. Dr Lorenzatti reported grants from Amgen, Arrowhead, Ionis, MSD, and Novartis outside the submitted work. Dr Oguz reported personal fees from Novo Nordisk during the conduct of the study and personal fees from AstraZeneca, Boehringer Ingelheim, Lilly, and Novo Nordisk outside the submitted work. Dr Mankovsky reported personal fees from Novo Nordisk during the conduct of the study and personal fees from AstraZeneca, Boehringer Ingelheim, Sanofi, and Servier outside the submitted work. Dr Deerochanawong reported grants from Novo Nordisk during the conduct of the study and personal fees from Abbott, Amgen, AstraZeneca, Boehringer Ingelheim, Lilly, Novo Nordisk, and Roche outside the submitted work. Dr Gorgojo-Martinez reported research fees from Novo Nordisk during the conduct of the study; grants from Mundipharma; and personal fees from AstraZeneca, Boehringer Ingelheim, Menarini, and Novo Nordisk outside the submitted work. Dr Bain reported payments for clinical activity in the SOUL trial from Novo Nordisk during the conduct of the study. Dr McGuire reported executive committee fees from Novo Nordisk during the conduct of the study and personal fees from Alveus, Amgen, AstraZeneca, Boehringer Ingelheim, Kailera, Lexicon, Lilly, Metsera, Neurotronic, New Amsterdam, Novartis, Novo Nordisk, Regor, Roche Genentech, and Zealand outside the submitted work. Dr Buse reported grants from Novo Nordisk during the conduct of the study; personal fees from Aardvark Therapeutics, Altimmune, Alveus Therapeutics, Amgen, Antag, AstraZeneca, Aqua Medical, Boehringer Ingelheim, Corcept Therapeutics, Dexcom, Eli Lilly, embecta, General Medicines Inc, GentiBio, Insulet, Kayothera, Metsera, MiniMed, Novo Nordisk, Recordati, Sparrow Pharmaceuticals, Tandem, Vertex, vTv Therapeutics, and Zealand; grants from Corcept Therapeutics , Dexcom, GentiBio, and Novo Nordisk; and holding stock options in Glyscend, Mellitus Health, Metsera, Pendulum Therapeutics, Praetego, and Stability Health outside the submitted work. No other disclosures were reported.
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