Patients with type 2 diabetes who received once-weekly semaglutide  had statistically greater reductions in HbA1c and body weight compared with those treated with dulaglutide, according to findings from the SUSTAIN 7 trial. The full study has been published in The Lancet Diabetes & Endocrinology.

Semaglutide and dulaglutide are both glucagon-like peptide-1 (GLP-1) receptor agonists.

The Phase 3b, open-label, parallel-group, 40-week trial evaluated the safety and efficacy of semaglutide 0.5 mg (n=301) vs dulaglutide 0.75 mg (n=299) and semaglutide 1.0 mg (n=300) vs dulaglutide 1.5 mg (n=299), when added to metformin, in adults who had type 2 diabetes with HbA1c 7.0–10.5% on metformin monotherapy.

The primary outcome measure was change in HbA1c from baseline after 40 weeks of treatment. Secondary endpoints included change in body weight from baseline to Week 40 and an HbA1c target of <7.0% at 40 weeks.


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Results showed a 1.5% reduction in baseline HbA1c after treatment with semaglutide 0.5 mg vs a 1.1% reduction with dulaglutide 0.75 mg (estimated treatment difference [ETD] -0.40%, 95% CI: -0.55, -0.25; <.0001). When comparing semaglutide 1.0 mg to dulaglutide 1.5 mg, there was a 1.8% vs a 1.4% reduction, respectively (ETD -0.41%, 95% CI: -0.57 to -0.25; <.0001).

Significantly more patients treated with semaglutide achieved the American Diabetes Association treatment target of HbA1c <7.0% (68% and 79% on 0.5 mg and 1.0 mg semaglutide vs 52% and 67% on 0.75 mg and 1.5 mg dulaglutide).

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Regarding body weight, there was a mean reduction of 4.6kg with semaglutide 0.5 mg vs a 2.3 kg reduction with dulaglutide 0.75 mg from baseline (ETD -2.26kg, 95% CI: -3.02 to -1.51; <.0001). When comparing semaglutide 1.0 mg to dulaglutide 1.5 mg, there was a 6.5 kg reduction vs a 3.0 kg reduction, respectively (ETD -3.55 kg, 95% CI: -4.32 to -2.78; <.0001).

Gastrointestinal disorders were the most commonly noted adverse events, as well as the most common reason for treatment discontinuation. 

“At low and high doses, semaglutide was superior to dulaglutide in improving glycemic control and reducing body weight, enabling a significantly greater number of patients with type 2 diabetes to achieve clinically meaningful glycemic targets and weight loss, with a similar safety profile,” concluded lead author Richard E. Pratley, MD. 

Reference

Pratley RE, Aroda VR, Lingvay I, et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial [published online January 31, 2018]. Lancet Diabetes Endocrinol. doi: 10.1016/S2213-8587(18)30024-X

This article originally appeared on MPR