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Introduction <p>Clinical trials have demonstrated greater glycemic control and weight loss with once-weekly (OW) semaglutide versus other anti-diabetes medications, including sodium-glucose co-transporter&#xa0;2 inhibitors (SGLT2is) in adults with type&#xa0;2 diabetes (T2D), yet real-world evidence is limited.</p> Methods <p>This observational study of adults with uncontrolled T2D (HbA1c ≥ 7.0%) initiating semaglutide OW or SGLT2is (January 2018–February 2022; first prescription = index) utilized linked data from IQVIA PharMetrics® Plus adjudicated claims and Ambulatory Electronic Medical Records databases. Among the all semaglutide OW cohort and subgroups (1: persistent [≤ 60-day gap in semaglutide OW supply]; 2: receiving maximum dose ≥ 1&#xa0;mg; and 3: persistent and ≥ 1&#xa0;mg dose), changes in weight, body mass index (BMI), and glycated hemoglobin (HbA1c) outcomes from baseline to 1&#xa0;year post index were descriptively compared. For the main analysis, changes in weight, BMI, HbA1c, and all-cause healthcare resource utilization (HCRU) after 1&#xa0;year were compared among adjusted semaglutide OW and comparator SGLT2i cohorts, following inverse probability of treatment weighting (IPTW).</p> Results <p>The all semaglutide OW cohort included 772 patients, and IPTW adjusted cohorts included 416 semaglutide OW patients and 1093 SGLT2i patients. Significant (<i>P</i> &lt; 0.0001) mean changes from baseline were observed in the all semaglutide OW cohort and all subgroups, in weight (kg [all: − 4.4; 1: − 5.0; 2: − 4.9; 3: − 5.2]), BMI (kg/m<sup>2</sup> [all: − 1.5; 1: − 1.8; 2: − 1.8; 3: − 1.9]), and HbA1c (% [all: − 1.5; 1: − 1.7; 2: − 1.5; 3: − 1.6]). Post-IPTW adjustment, the semaglutide OW cohort had significantly greater mean reductions versus the SGLT2i cohort in weight (− 4.4 versus − 3.4&#xa0;kg, <i>P</i> = 0.0061), BMI (− 1.5 versus − 1.1&#xa0;kg/m<sup>2</sup>, <i>P</i> = 0.0013), and HbA1c (− 1.6 versus − 1.2%, <i>P</i> &lt; 0.0001), with similar all-cause HCRU.</p> Conclusion <p>Adults with T2D initiating semaglutide OW in the real-world had significant decreases in weight, BMI, and HbA1c after 1&#xa0;year, with greater improvements versus SGLT2i, and similar HCRU.</p>

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Once-Weekly Semaglutide Versus Sodium-Glucose Co-transporter 2 Inhibitors: Real-World Impact on Weight, HbA1c, and Healthcare Resource Utilization in Type 2 Diabetes (PAUSE)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月27日

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  • James Amamoo,
  • Riddhi Doshi,
  • Joshua Noone,
  • Lin Xie,
  • Cory Gamble,
  • Mico Guevarra,
  • Victoria Divino,
  • Justin Chen,
  • Aaron King

摘要

Introduction

Clinical trials have demonstrated greater glycemic control and weight loss with once-weekly (OW) semaglutide versus other anti-diabetes medications, including sodium-glucose co-transporter 2 inhibitors (SGLT2is) in adults with type 2 diabetes (T2D), yet real-world evidence is limited.

Methods

This observational study of adults with uncontrolled T2D (HbA1c ≥ 7.0%) initiating semaglutide OW or SGLT2is (January 2018–February 2022; first prescription = index) utilized linked data from IQVIA PharMetrics® Plus adjudicated claims and Ambulatory Electronic Medical Records databases. Among the all semaglutide OW cohort and subgroups (1: persistent [≤ 60-day gap in semaglutide OW supply]; 2: receiving maximum dose ≥ 1 mg; and 3: persistent and ≥ 1 mg dose), changes in weight, body mass index (BMI), and glycated hemoglobin (HbA1c) outcomes from baseline to 1 year post index were descriptively compared. For the main analysis, changes in weight, BMI, HbA1c, and all-cause healthcare resource utilization (HCRU) after 1 year were compared among adjusted semaglutide OW and comparator SGLT2i cohorts, following inverse probability of treatment weighting (IPTW).

Results

The all semaglutide OW cohort included 772 patients, and IPTW adjusted cohorts included 416 semaglutide OW patients and 1093 SGLT2i patients. Significant (P < 0.0001) mean changes from baseline were observed in the all semaglutide OW cohort and all subgroups, in weight (kg [all: − 4.4; 1: − 5.0; 2: − 4.9; 3: − 5.2]), BMI (kg/m2 [all: − 1.5; 1: − 1.8; 2: − 1.8; 3: − 1.9]), and HbA1c (% [all: − 1.5; 1: − 1.7; 2: − 1.5; 3: − 1.6]). Post-IPTW adjustment, the semaglutide OW cohort had significantly greater mean reductions versus the SGLT2i cohort in weight (− 4.4 versus − 3.4 kg, P = 0.0061), BMI (− 1.5 versus − 1.1 kg/m2, P = 0.0013), and HbA1c (− 1.6 versus − 1.2%, P < 0.0001), with similar all-cause HCRU.

Conclusion

Adults with T2D initiating semaglutide OW in the real-world had significant decreases in weight, BMI, and HbA1c after 1 year, with greater improvements versus SGLT2i, and similar HCRU.