Impact of semaglutide vs canagliflozin on body composition in patients with T2D

  • McCrimmon RJ & al.
  • Diabetologia
  • 2 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with uncontrolled type 2 diabetes (T2D) on stable-dose metformin therapy, no significant difference was observed in body composition with semaglutide and canagliflozin.
  • Semaglutide and canagliflozin were associated with numerical reduction in total and visceral fat mass.

Why this matters

  • Findings warrant further study to determine the specific effects of treatments using glucagon-like peptide-1 receptor agonist and sodium-glucose co-transporter-2 inhibitor classes on components of body composition in the presence of placebo group.

Study design

  • A substudy of the SUSTAIN 8 trial included 178 patients with T2D who received stable daily dose of metformin and underwent dual-energy X-ray absorptiometry (DXA) scanning at screening.
  • All patients were randomly assigned (1:1) to receive semaglutide (once weekly; n=88) or canagliflozin (once daily; n=90).
  • Main outcomes: changes in total fat mass, lean mass, visceral fat mass (kg and %-point) and ratio of total fat mass to total lean mass from baseline to 52 weeks.
  • Funding: Novo Nordisk A/S, Denmark.

Key results

  • Changes in body composition by weight (kg):
    • At 52 weeks, no significant difference was observed between semaglutide and canagliflozin group in:
      • total fat (estimated treatment difference [ETD], −0.79; 95% CI, −2.10 to 0.51) and total lean (ETD, −0.78; 95% CI, −1.61 to 0.04) mass; and
      • visceral fat mass (ETD, −0.07; 95% CI, −0.20 to 0.06).
  • Changes in body composition by percentage-point (%-point):
    • At 52 weeks, no significant difference was observed between semaglutide and canagliflozin group in:
      • total fat (ETD, −0.21; 95% CI, −1.26 to 0.84) and
      • visceral fat (ETD, −1.38; 95% CI, −3.65 to 0.88) mass.
  • Reduction in body composition evaluated by the fat-to-lean-mass ratio were similar between the semaglutide and canagliflozin group (ETD, −0.01; 95% CI, −0.04 to 0.02).

Limitations

  • Lack of systematic collection of off-treatment DXA scans.