In patients with type 2 diabetes on oral antidiabetic therapy, once-weekly semaglutide 1.0 mg significantly improved HbA1c and reduced body weight more than once-weekly exenatide ER 2.0 mg over 56 weeks, with a higher rate of gastrointestinal side effects for semaglutide but more injection-site reactions for exenatide.
PICO Summary
Population:
Adults with type 2 diabetes (n=813), on stable oral antidiabetic medications (metformin and/or sulfonylureas or thiazolidinediones).
Intervention:
Once-weekly semaglutide, 1.0 mg, over 56 weeks.
Comparison:
Once-weekly exenatide ER, 2.0 mg.
Outcome:
- Efficacy: HbA1c reduction was 1.5% with semaglutide vs. 0.9% with exenatide; weight loss was 5.6 kg for semaglutide compared to 1.9 kg for exenatide.
- Safety and Tolerability: Gastrointestinal adverse effects (e.g., nausea) were more frequent with semaglutide (41.8%) compared to exenatide (33.3%), whereas exenatide had a higher rate of injection-site reactions (22.0%).
Clinical Summary
Main Finding:
Semaglutide outperformed exenatide ER in glycaemic control and weight reduction over 56 weeks in type 2 diabetes patients.
Clinical Relevance:
Once-weekly semaglutide may be a more effective alternative to exenatide ER for patients prioritising weight and glycaemic control, though gastrointestinal side effects may require management.
Study Overview:
- Type of Study: Open-label, randomised, active-controlled trial.
- Sample Size & Population: 813 adults with type 2 diabetes.
- Intervention Duration & Doses: 56-week trial with semaglutide (1.0 mg) versus exenatide ER (2.0 mg).
- Comparison: Exenatide ER (2.0 mg weekly).
Outcomes:
- Primary Measure (HbA1c): Semaglutide achieved HbA1c reductions of 1.5%, significantly superior to exenatide’s 0.9% reduction.
- Secondary Measure (Body Weight): Weight loss of 5.6 kg with semaglutide vs. 1.9 kg with exenatide.
- Safety Profile: Semaglutide had higher gastrointestinal events, whereas exenatide had more injection-site reactions.
Considerations:
The study’s open-label design may impact patient-reported outcomes. Longer studies could further assess differences in long-term safety profiles.
Reference:
Ahmann, A. J., et al. (2018). Diabetes Care, 41(2), 258-266. doi:10.2337/dc17-0417
Disclosure: This article on Hormone Insight was created with both human and AI assistance. The human expert editor reviewed the article before publication to ensure accuracy, quality, and clarity.
