Efficacy of semaglutide by background sodium-glucose co-transporter-2 inhibitor: A Post Hoc Analysis of SUSTAIN 9

The SUSTAIN clinical trials demonstrated the efficacy and safety of once-weekly subcutaneous semaglutide, a glucagon-like peptide 1 analog for the treatment of type 2 diabetes (T2D). SUSTAIN 9 investigated semaglutide 1.0mg vs placebo as add-on to a stable dose of sodium-glucose co transporter-2 inhibitor (SGLT-2i) therapy, with or without metformin or a sulfonylurea. The primary and secondary endpoints were, respectively, change from baseline in HbA1c and body weight at week 30. In this post hoc analysis, SUSTAIN 9 data were analyzed by Background SGLT-2i (empagliflozin, canagliflozin, dapagliflozin or other [ipragliflozin, luseogliflozin and tofogliflozin; drugs available only in Japan]). In total, 302 subjects were randomized to semaglutide or placebo. Reductions in HbA1c and body weight were greater with semaglutide vs placebo. There was no significant interaction between Background SGLT-2i and treatment effect (interaction p-value > 0.05 for both endpoints), with a smaller observed weight reduction in the 'Other' group. No safety concerns were identified when adding semaglutide to SGLT-2i therapy. No diabetic ketoacidosis or lower limb amputation events occurred. In conclusion, in subjects with T2D already receiving an SGLT-2i, semaglutide generally resulted in superior HbA1c and body weight reductions vs placebo, regardless of Background SGLT-2i therapy. Joachim Kienhöfer is just presenting on behalf of the author group (Sponsored by Novo Nordisk A / S). Interessenkonflikt Joachim Kienhöfer ist als Medical Manager bei der Novo Nordisk Pharma GmbH fest angestellt.