Semaglutide Goes Head-to-Head With Dulaglutide in Type 2 Diabetes Trial

Patients with inadequately controlled type 2 diabetes were included in the study
Patients with inadequately controlled type 2 diabetes were included in the study

Patients with type 2 diabetes who received once-weekly semaglutide  had statistically greater reductions in HbA1c and body weight compared with those treated with dulaglutide, according to findings from the SUSTAIN 7 trial. The full study has been published in The Lancet Diabetes & Endocrinology.

Semaglutide and dulaglutide are both glucagon-like peptide-1 (GLP-1) receptor agonists. The Phase 3b, open-label, parallel-group, 40-week trial evaluated the safety and efficacy of semaglutide 0.5mg (n=301) vs dulaglutide 0.75mg (n=299) and semaglutide 1.0mg (n=300) vs dulaglutide 1.5mg (n=299), when added to metformin, in adults who had type 2 diabetes with HbA1c 7.0–10.5% on metformin monotherapy. The primary outcome measure was change in HbA1c from baseline after 40 weeks of treatment. Secondary endpoints included change in body weight from baseline to Week 40 and an HbA1c target of <7.0% at 40 weeks.

Results showed a 1.5% reduction in baseline HbA1c after treatment with semaglutide 0.5mg vs a 1.1% reduction with dulaglutide 0.75mg (estimated treatment difference [ETD] -0.40%, 95% CI: -0.55, -0.25; P<0.0001). When comparing semaglutide 1.0mg to dulaglutide 1.5mg, there was a 1.8% vs a 1.4% reduction, respectively (ETD -0.41%, 95% CI: -0.57 to -0.25; P<0.0001). Significantly more patients treated with semaglutide achieved the American Diabetes Association treatment target of HbA1c <7.0% (68% and 79% on 0.5mg and 1.0mg semaglutide vs 52% and 67% on 0.75mg and 1.5mg dulaglutide).

Regarding body weight, there was a mean reduction of 4.6kg with semaglutide 0.5mg vs a 2.3kg reduction with dulaglutide 0.75mg from baseline (ETD -2.26kg, 95% CI: -3.02 to -1.51; P<0.0001). When comparing semaglutide 1.0mg to dulaglutide 1.5mg, there was a 6.5kg reduction vs a 3.0kg reduction, respectively (ETD -3.55kg, 95% CI: -4.32 to -2.78; P<0.0001). 

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Gastrointestinal disorders were the most commonly noted adverse events, as well as the most common reason for treatment discontinuation. 

"At low and high doses, semaglutide was superior to dulaglutide in improving glycemic control and reducing body weight, enabling a significantly greater number of patients with type 2 diabetes to achieve clinically meaningful glycemic targets and weight loss, with a similar safety profile," concluded lead author Richard E. Pratley, MD. 

For more information visit thelancet.com.