Semaglutide Superior to Other GLP-1 Analogues as Add-On to Basal Insulin in T2D

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Once-weekly semaglutide 1.0 mg was also equally effective at reducing systolic blood pressure compared with liraglutide 1.8 mg.
Once-weekly semaglutide 1.0 mg was also equally effective at reducing systolic blood pressure compared with liraglutide 1.8 mg.

Semaglutide, a glucagon-like peptide-1 (GLP-1) analogue, given once weekly at a dose of 1.0 mg as an add-on to basal insulin, was associated with significantly greater reductions in glycated hemoglobin (HbA1c) and body weight compared with all other GLP-1 receptor agonists (RAs), according to new findings published in Diabetes Therapy.

A network meta-analysis and systematic literature review was conducted to evaluate the efficacy and safety of once-weekly semaglutide compared with other GLP-1 RAs when added to basal insulin in patients with type 2 diabetes. A total of 8 studies met the inclusion criteria for the base-case analyses. The results showed that as compared with other agents, once-weekly semaglutide 1.0 mg was associated with significantly greater reductions in HbA1c (−0.88% to −1.39%) and weight reduction (−1.49 to −4.69 kg).

Across all analyses, semaglutide 1.0 mg was the highest-ranked GLP-1 RA, with a median rank of 1 and a surface under the cumulative ranking curve score of 100% for all glycemic outcomes, indicating that it was the most effective treatment. At a 1.0-mg dose, it was also equally effective at lowering systolic blood pressure as compared with liraglutide 1.8 mg; at a 0.5-mg dose, semaglutide significantly reduced HbA1c compared with all other GLP-1 RAs except for once-daily liraglutide 1.8 mg.

"Additional analyses showed that the significantly greater reductions in HbA1c and body weight with once-weekly semaglutide 1.0 mg are also supported by significant improvements in [fasting plasma glucose] and significantly higher odds of achieving the HbA1c targets of <7% and ≤ 6.5% compared with other GLP-1 RAs," wrote the authors.

Disclosure: The study and article processing charges were funded by Novo Nordisk. Several authors disclosed being either an employee or shareholder of Novo Nordisk and/or DRG Abacus. A full list is available on the journals' website.

Reference

Witkowski M, Wilkinson L, Webb N, Weids A, Glah D, Vrazic H. A systematic literature review and network meta-analysis comparing once-weekly semaglutide with other glp-1 receptor agonists in patients with type 2 diabetes previously receiving basal insulin [published online April 30, 2018]. Diabetes Ther. doi: 10.1007/s13300-018-0428-y

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