Efficacy of Semaglutide by Background Sodium–Glucose Co-Transporter-2 Inhibitor: a Post Hoc Analysis of SUSTAIN 9
Abstract
The SUSTAIN clinical trials demonstrated the efficacy and safety of once-weekly subcutaneous semaglutide, a glucagon-like peptide 1 analog for the treatment of type 2 diabetes (T2D). SUSTAIN 9 investigated semaglutide 1.0 mg vs. placebo as add-on to a stable dose of sodium-glucose co transporter-2 inhibitor (SGLT2i) therapy, with or without metformin or a sulfonylurea. The primary and secondary endpoints were, respectively, change from baseline in HbA1c and body weight at week 30. In this post hoc analysis, SUSTAIN 9 data were analyzed by background SGLT2i (empagliflozin, canagliflozin, dapagliflozin or other [ipragliflozin, luseogliflozin and tofogliflozin; drugs available only in Japan]). In total, 302 subjects were randomized to semaglutide or placebo. Reductions in HbA1c and body weight were greater with semaglutide vs. placebo. There was no significant interaction between background SGLT2i and treatment effect (interaction p-value >0.05 for both endpoints), with a smaller observed weight reduction in the ‘Other’ group (Table). No safety concerns were identified when adding semaglutide to SGLT2i therapy. No diabetic ketoacidosis or lower limb amputation events occurred. In conclusion, in subjects with T2D already receiving an SGLT2i, semaglutide generally resulted in superior HbA1c and body weight reductions vs. placebo, regardless of background SGLT2i therapy. Disclosure B. Zinman: Advisory Panel; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc.,…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 302 participants or records.
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