An indirect treatment comparison of the efficacy of semaglutide 1.0 mg versus dulaglutide 3.0 and 4.5 mg

Richard E Pratley, Andrei-Mircea Catarig, Ildiko Lingvay, Adie Viljoen, Abby Paine, Jack Lawson, Barrie Chubb, Anders Gorst-Rasmussen, Nino Miresashvili, Richard E Pratley, Andrei-Mircea Catarig, Ildiko Lingvay, Adie Viljoen, Abby Paine, Jack Lawson, Barrie Chubb, Anders Gorst-Rasmussen, Nino Miresashvili

Abstract

Aim: To compare the effects of semaglutide 1.0 mg versus dulaglutide 3.0 and 4.5 mg on HbA1c and body weight in patients with type 2 diabetes.

Materials and methods: A Bucher indirect comparison was conducted to compare efficacy outcomes of semaglutide 1.0 mg versus dulaglutide 3.0 and 4.5 mg using published results from the SUSTAIN 7 and AWARD-11 trials. Sensitivity analyses using individual patient data from SUSTAIN 7 and aggregate data from AWARD-11 were conducted to explore the impact of adjustment for cross-trial imbalances in baseline characteristics.

Results: Semaglutide 1.0 mg significantly reduced HbA1c versus dulaglutide 3.0 mg, with an estimated treatment difference (ETD) of -0.24%-points (95% confidence interval [CI] -0.43, -0.05), with comparable reductions in HbA1c versus dulaglutide 4.5 mg with an ETD of -0.07%-points (95% CI -0.26, 0.12). Semaglutide 1.0 mg significantly reduced body weight versus dulaglutide 3.0 and 4.5 mg with an ETD of -2.65 kg (95% CI -3.57, -1.73) and -1.95 kg (95% CI -2.87, -1.03), respectively. Sensitivity analyses supported the primary analysis findings.

Conclusions: This indirect comparison showed significantly greater reductions in HbA1c with semaglutide 1.0 mg versus dulaglutide 3.0 mg and comparable HbA1c reductions versus dulaglutide 4.5 mg. Semaglutide 1.0 mg significantly reduced body weight versus both dulaglutide 3.0 and 4.5 mg. With several glucagon-like peptide-1 receptor agonists available, information regarding their comparative efficacy can be valuable to clinicians.

Keywords: GLP-1 receptor agonist; dulaglutide; indirect comparison; semaglutide; type 2 diabetes.

Conflict of interest statement

RP reports consulting fees from AstraZeneca; consulting fees from Glytec, LLC; grants from Hanmi Pharmaceutical Co.; grants and consulting fees from Janssen; consulting fees from Merck; grants from Metavention; consulting fees from Mundipharma; grants, speaker fees and consulting fees from Novo Nordisk; consulting fees from Pfizer; grants from Poxel SA; grants and consulting fees from Sanofi; consulting fees from Scohia Pharma Inc.; consulting fees from Sun Pharmaceutical Industries; and personal consulting fees from Sanofi US Services, Inc. Except for consulting fees in February 2018 and June 2018 from Sanofi US Services, Inc., RP's services were paid for directly to AdventHealth, a non‐profit organization. AMC is an employee and shareholder of Novo Nordisk A/S. IL has received research funding, advisory/consulting fees and/or other support from Novo Nordisk, Eli Lilly, Sanofi, AstraZeneca, Boehringer Ingelheim, Janssen, Intercept, Intarcia, TARGETPharma, Merck, Pfizer, Novartis, GI Dynamics, Mylan, Mannkind, Valeritas, Bayer and Zealand Pharma. AV has conducted research studies funded by, served as advisor for, and received lecture honoraria from Amgen, AstraZeneca, Boehringer, Daiichi, Eli Lilly, Napp, Novartis, Novo Nordisk, MannKind, Pfizer, Regeneron, Sanofi, Takeda and Tosoh. AP received consultancy fees to develop a statistical analysis plan for the analyses presented in this manuscript; she has also received personal fees from Novo Nordisk, Sanofi and Ultragenyx. JL is an employee of Novo Nordisk A/S. BC is an employee and a shareholder of Novo Nordisk A/S. AGR is an employee and minor stakeholder in Novo Nordisk A/S. NM is an employee of Novo Nordisk A/S.

© 2021 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Network of evidence for semaglutide 1.0 mg versus dulaglutide 3.0 and 4.5 g. QW, once‐weekly
FIGURE 2
FIGURE 2
Efficacy outcomes of semaglutide (Sema) 1.0 mg versus dulaglutide (Dula) 3.0 and 4.5 mg. (A) Change in HbA1c from baseline; (B) change in bodyweight (kg) from baseline. Primary Bucher analysis, sensitivity analyses 1‐4

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Source: PubMed

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