Semaglutide as a therapeutic option for elderly patients with type 2 diabetes: Pooled analysis of the SUSTAIN 1-5 trials

Mark Warren, Louis Chaykin, David Trachtenbarg, Gurudutt Nayak, Nelun Wijayasinghe, Bertrand Cariou, Mark Warren, Louis Chaykin, David Trachtenbarg, Gurudutt Nayak, Nelun Wijayasinghe, Bertrand Cariou

Abstract

The efficacy and safety of semaglutide vs comparators in non-elderly (<65 years) and elderly (≥65 years) patients with type 2 diabetes (T2D) across the SUSTAIN 1-5 trials were evaluated. Patients were randomized to once-weekly subcutaneous semaglutide (0.5 or 1.0 mg) vs placebo, sitagliptin, exenatide or insulin. The primary objective was change in HbA1c and secondary objectives were changes in body weight and safety. Mean HbA1c decreased from baseline by 1.2%-1.5% and 1.5%-1.9% vs 0%-0.9% (non-elderly, n = 3045) and by 1.3%-1.5% and 1.2%-1.8% vs 0.2%-1.0% (elderly, n = 854) with semaglutide 0.5 and 1.0 mg vs comparators. Similar reductions from baseline in mean body weight with semaglutide occurred in both age groups. Similar proportions of patients experienced adverse events; premature treatment discontinuations were higher in elderly vs non-elderly patients. No increased risk of severe or blood glucose-confirmed hypoglycaemia was seen with semaglutide vs comparators between age groups. Semaglutide had a comparable efficacy and safety profile in non-elderly and elderly patients across the SUSTAIN 1-5 trials, making it an effective treatment option for elderly patients with T2D.

Keywords: GLP-1 analogue; antidiabetic drug; glycaemic control; incretin therapy; type 2 diabetes.

Conflict of interest statement

M. W. has received research support from Novo Nordisk, Eli Lilly, Janssen, Shire, Pfizer, Mylan and Sanofi; is on the advisory panel of Novo Nordisk, Sanofi and Eli Lilly; and is on the speaker's bureau of Novo Nordisk, Eli Lilly, Janssen, AstraZeneca, Sanofi, Merck, Shire and Mannkind. L. C. is a consultant for Novo Nordisk and is on the advisory board of Intarcia Therapeutics. D. T. is on the advisory panel of Novo Nordisk and has received research support from Novo Nordisk, Sanofi Aventis and Sanofi. G. N. and N. W. are full‐time employees of Novo Nordisk. B. C. is a consultant for Novo Nordisk; has received research support from Pfizer, Sanofi and Regeneron; and has received honoraria from Amgen, Pierre Fabre, Eli Lilly, MSD, Merck & Co, Novo Nordisk, Regeneron and Sanofi.

© 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Change from baseline to end of treatment in HbA1c (A) and BW (B) by age group in SUSTAIN 1‐5. Abbreviations: BW, body weight; exenatide ER, exenatide extended release; IGlar, insulin glargine. In part A, all tests for treatment by subgroup interaction (P < 0.02). In part B, all tests for treatment by subgroup interaction (<65/≥65 years) were non‐significant. Non‐elderly: <65 years; elderly: ≥65 years

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