In patients with type 2 diabetes, weekly subcutaneous semaglutide significantly reduced HbA1c and body weight compared to dulaglutide at similar doses, though it was associated with higher gastrointestinal side effects.
PICO Summary
Population: Adults aged ≥18 years with type 2 diabetes inadequately controlled on metformin, with HbA1c levels between 7.0% and 10.5%.
Intervention: Once-weekly semaglutide injections at doses of 0.5 mg and 1.0 mg.
Comparison: Once-weekly dulaglutide injections at doses of 0.75 mg and 1.5 mg.
Outcome:
- Efficacy: Semaglutide achieved greater HbA1c reduction at both dose levels than dulaglutide (p<0.0001) and resulted in superior weight loss.
- Safety and Tolerability: Gastrointestinal side effects were more common with semaglutide, leading to higher discontinuation rates.
Clinical Summary
Main Finding:
Semaglutide demonstrated superior efficacy over dulaglutide in reducing HbA1c and promoting weight loss at comparable doses in patients with type 2 diabetes.
Clinical Relevance:
These results support semaglutide as a potent alternative to dulaglutide for glycaemic control and weight management in type 2 diabetes, though gastrointestinal side effects warrant consideration.
Study Overview:
- Type of Study: Phase 3b, randomised, open-label trial.
- Sample Size & Population: 1,201 adults with type 2 diabetes.
- Intervention Duration & Doses: 40 weeks of weekly semaglutide (0.5 mg or 1.0 mg) compared with dulaglutide (0.75 mg or 1.5 mg).
- Comparison: Dulaglutide as an active comparator.
Outcomes:
- Primary Measure (HbA1c): Semaglutide 0.5 mg and 1.0 mg achieved significantly greater HbA1c reduction than dulaglutide 0.75 mg and 1.5 mg, respectively.
- Secondary Measure (Body Weight): Semaglutide provided more pronounced weight loss compared to dulaglutide.
- Safety Profile: Gastrointestinal side effects were notably higher in the semaglutide groups, leading to discontinuations.
Considerations: The high incidence of gastrointestinal side effects with semaglutide may affect adherence; thus, patient selection and counselling are essential. Further studies might clarify long-term safety and tolerability.
Reference:
Pratley, R. E., et al. (2018). The Lancet Diabetes & Endocrinology, 6(4), 275-286. doi:10.1016/S2213-8587(18)30024-X
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.
