Once-Weekly Semaglutide 1 mg vs Empagliflozin 25 mg as Add-On to Metformin Monotherapy in Patients with Type 2 Diabetes: a Meta-Regression Analysis of Individual Patient Data
Abstract
There are no published head-to-head trials of once-weekly semaglutide 1 mg vs. once-daily empagliflozin 25 mg in type 2 diabetes (T2D). We indirectly compared the pooled semaglutide arms in SUSTAIN 2, 3 and 8 with the empagliflozin arm in PIONEER 2 using individual patient data, for those on metformin monotherapy. Although all trials had similar inclusion criteria and duration, meta-regression analyses adjusting for effect modifiers and prognostic factors further controlled for differences in design and population. Mean baseline characteristics were similar with semaglutide and empagliflozin (age: 56 vs. 58 years, diabetes duration: 7 vs. 8 years, BMI: 33 vs. 33 kg/m2, HbA1C: 8.2% vs. 8.1% respectively). Semaglutide reduced mean HbA1C by -1.4 vs. -0.8%-point with empagliflozin (p<0.001), and body weight by -5.3 vs. -3.7 kg with empagliflozin (p<0.001). Sensitivity analyses. which were performed to assess robustness of these findings, supported these results. A significantly greater proportion of patients on semaglutide vs. empagliflozin also achieved HbA1C targets and clinically relevant weight-loss targets. In this indirect comparison, pooled semaglutide 1mg provided significantly greater HbA1C reduction and body weight-loss compared with empagliflozin 25mg in patients with T2D on metformin monotherapy. Publication History Article published online: 26 May 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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