Real-world use of once-weekly semaglutide in patients with type 2 diabetes: pooled analysis of data from four SURE studies by baseline characteristic subgroups

Abstract

Introduction: This post hoc pooled analysis of four real-world studies (SURE Canada, Denmark/Sweden, Switzerland and UK) aimed to characterize the use of once-weekly (OW) semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), in patients with type 2 diabetes (T2D).

Research design and methods: The Semaglutide Real-world Evidence (SURE) studies had a duration of ~30 weeks. Changes in glycated hemoglobin (HbA1c) and body weight (BW) were analyzed for the overall population and the following baseline subgroups: GLP-1RA-naïve/GLP-1RA switchers; body mass index <25/≥25-<30/≥30-<35/≥35 kg/m2; age <65/≥65 years; HbA1c <7%/≥7-≤8%/>8-≤9%/>9%; T2D duration <5/≥5-<10/≥10 years. Data for patients achieving treatment targets were analyzed in the overall population and the baseline HbA1c ≥7% subgroup.

Results: Of 1212 patients, 960 were GLP-1RA-naïve and 252 had switched to semaglutide from another GLP-1RA. In the overall population, HbA1c was reduced from baseline to end of study (EOS) by -1.1% point and BW by -4.7 kg; changes were significant for all subgroups. There were significantly larger reductions of HbA1c and BW in GLP-1RA-naïve versus GLP-1RA switchers and larger reductions in HbA1c for patients with higher versus lower baseline HbA1c. At EOS, 52.6% of patients in the overall population achieved HbA1c <7%. No new safety concerns were identified in any of the completed SURE studies.

Conclusions: In this pooled analysis, patients with T2D initiating OW semaglutide showed significant improvements from baseline to EOS in HbA1c and BW across various baseline subgroups, including patients previously treated with a GLP-1RA other than semaglutide, supporting OW semaglutide use in clinical practice.

Trail registration numbers: NCT03457012; NCT03631186; NCT03648281; NCT03876015.

Keywords: glucagon-like peptide 1; glycated hemoglobin A; incretins.

Conflict of interest statement

Competing interests: J-FY reports receiving grants from Novo Nordisk during the conduct of the study; grants and personal fees from Novo Nordisk, Eli Lilly, Boehringer Ingelheim, Merck, Janssen, AstraZeneca, and Sanofi, all outside the submitted work. UB reports personal fees for participation in a scientific advisory board from Novo Nordisk, outside the submitted work. A-MC, AC and UE are employees of Novo Nordisk, and A-MC and UE own stock in the company. SC reports consultancy payment for Novo Nordisk (paid to his employer). NRE reports payment for lecturing and reimbursement for participation in scientific advisory boards from Novo Nordisk (paid to her employer), outside the submitted work. PH reports personal fees from AstraZeneca, Eli Lilly, and Novo Nordisk, outside the submitted work. STK reports grants and personal fees for lectures and/or consultancy from AstraZeneca, Boehringer Ingelheim, and Novo Nordisk, and personal fees for lectures and/or consultancy from MSD, Mundipharma and Sanofi, outside of the submitted work. JL reports compensation for clinical trial research, personal fees from continuing medical education events, outside the submitted work. TS reports grants from Abbott and Novo Nordisk outside the submitted work. BS reports fees for advisory board meetings and lectures from Novo Nordisk. GR reports research funding from Novo Nordisk.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1

(A) Change in HbA1c from baseline to EOS in overall population and subgroups; (B) change in body weight from baseline to EOS in overall population and subgroups. Data are from the full analysis set, in-study period that represents the time period during which patients are considered to be in the study, regardless of semaglutide treatment status. Response was analyzed using baseline T2D duration, age, BMI, time, time-squared, preinitiation use of DPP-4i, preinitiation use of insulin, preinitiation use of GLP-1RAs, GLP-1RA (except in ‘GLP-1RA experience’ subgroups), number of OADs used preinitiation (0–1/2+) and sex with random intercept and random time coefficient (slope). (A) All p values for change from baseline to week 30 are significant at <0.0001. Interaction p value for difference in change between subgroups: *p=0.0003; †0.0209; ‡0.9354; ‖0.1944; §0.3504. (B) All p values for change from baseline to week 30 are significant at <0.0001 except p=0.0092 for baseline BMI of 25 kg/m2. Interaction p value for difference in change between subgroups: *p<0.0001; †0.8730; ‡0.5791; §0.8419; ‖0.7569. BMI, body mass index; DPP-4i, dipeptidyl peptidase-4 inhibitor; EOS, end of study; GLP-1RA, glucagon-like peptide-1 receptor agonist; HbA1c, glycated hemoglobin; OAD, oral antihyperglycemic drug; T2D, type 2 diabetes.

Figure 2

Proportions of patients achieving treatment targets at EOS. Data are based on the full analysis set. EOS, end of study; HbA1c, glycated hemoglobin; WL, weight loss.