Success for semaglutide in SUSTAIN 7 head to head trial with Trulicity(dulaglutide) in treatment of type 2 diabetes.- Novo Nordisk

Novo Nordisk announced the SUSTAIN 7 trial results , demonstrating that people with type 2 diabetes treated with once-weekly semaglutide experienced superior reduction in HbA1c and body weight compared to treatment with Trulicity (dulaglutide ). The 40-week trial investigated the efficacy and safety of 0.5 mg semaglutide compared with 0.75 dulaglutide and 1.0 mg semaglutide compared with 1.5 mg dulaglutide, when added to metformin. From a mean baseline HbA1c of 8.2%, 0.5 mg semaglutide achieved a statistically significant and superior reduction of 1.5% compared with a reduction of 1.1% with 0.75 mg dulaglutide. People treated with 1.0 mg semaglutide experienced a statistically significant and superior reduction of 1.8% compared with a reduction of 1.4% with 1.5 mg dulaglutide. Using the American Diabetes Association (ADA) treatment target of HbA1c below or equal to 7.0%, 69% of people treated with 0.5 mg semaglutide compared with 52% of people treated with 0.75 mg dulaglutide reached the treatment goal, and 79% of people treated with 1.0 mg semaglutide compared to 68% with 1.5 mg dulaglutide reached the treatment goal. Using the American Association of Clinical Endocrinologists (AACE) treatment target of HbA1c below or equal to 6.5%, 51% of people treated with 0.5 mg semaglutide compared with 36% of people treated with 0.75 mg dulaglutide reached the treatment goal, and 68% of people treated with 1.0 mg semaglutide compared to 49% with 1.5 mg dulaglutide reached the treatment goal. Furthermore, from a mean baseline body weight of 95 kg and a BMI of 33.5 kg/m2, people treated with 0.5 mg semaglutide experienced a statistically significant and superior weight loss of 4.6 kg compared to 2.3 kg with 0.75 mg dulaglutide. People treated with 1.0 mg semaglutide experienced a statistically significant and superior weight loss of 6.5 kg compared to 3.0 kg with 1.5 mg dulaglutide. 44% of people treated with 0.5 mg semaglutide compared with 23% of people treated with 0.75 mg dulaglutide achieved more or equal to 5% body weight loss and 63% of people with 1.0 mg semaglutide compared with 30% of people treated with 1.5 mg dulaglutide.

In the trial, semaglutide demonstrated a safe and well-tolerated profile consistent with results from the SUSTAIN programme. The most common adverse event for both semaglutide dosages was mild to moderate nausea, which was overall comparable to dulaglutide and diminished over time. Premature treatment discontinuation due to adverse events was less than 10% across all treatment groups. The number of people reporting an adverse event of diabetic retinopathy was low and comparable in both the semaglutide and dulaglutide groups (4 and 5 events, respectively).

Comment: Semaglutide is the once weekly follow up to liraglutide and in this head to head trial with Trulicity (dulaglutide) semaglutide showed lower blood sugar and weight loss .Also side effect retinopathy events linked to semaglutide were lowor in ths SUSTAIN 7 trial. Semaglutide has already shown a positive CV risk profile in an earlier trial and Trulicity has yet to report on this factor.