EASD 2019 — Once-weekly semaglutide beats canagliflozin for T2D control in metformin-treated patients


  • Brandon May
  • Conference Reports
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Takeaway

  • In patients with type 2 diabetes (T2D) whose disease was uncontrolled on a metformin-only regimen, once-weekly semaglutide was superior to once-daily canagliflozin for reducing HbA1c and body weight.

Why this matters

  • Combination therapies may be necessary to achieve glycemic control in patients with T2D who are unable to achieve optimal benefit with metformin monotherapy.

Study design

  • Patients with T2D were randomly assigned to either:
    • Once-weekly subcutaneous semaglutide 1.0 mg (n=394), or
    • Daily oral canagliflozin 300 mg (n=394).
  • Changes in body weight, safety, and achievement of prespecified HbA1c targets were also assessed.
  • Funding: Novo Nordisk.

Key results

  • At 52 weeks, semaglutide was associated with greater reductions in HbA1c compared with canagliflozin (mean, −1.5% vs −1.0%; estimated treatment difference [ETD], −0.49; 95% CI, −0.65 to −0.33; P<.0001>
  • A higher proportion of patients treated with semaglutide achieved HbA1c targets of
  • Semaglutide led to greater body weight reductions (−5.3 vs −4.2 kg; ETD, −1.06; 95% CI, −1.76 to −0.36; P=.0029).
  • The most common adverse events (AEs) with semaglutide were gastrointestinal (46.9%).
  • With canagliflozin, AEs were more commonly infectious (34.5%).

Limitations

  • Lack of data regarding participants’ diet and lifestyle.