TY - JOUR
T1 - Efficacy of once-weekly semaglutide vs empagliflozin added to metformin in type 2 diabetes
T2 - Patient-level meta-analysis
AU - Lingvay, Ildiko
AU - Capehorn, Matthew S.
AU - Catarig, Andrei Mircea
AU - Johansen, Pierre
AU - Lawson, Jack
AU - Sandberg, Anna
AU - Shaw, Robert
AU - Paine, Abby
N1 - Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Context: No head-to-head trials have directly compared once-weekly (OW) semaglutide, a human glucagon-like peptide-1 analog, with empagliflozin, a sodium–glucose co-transporter-2 inhibitor, in type 2 diabetes (T2D). Objective: We indirectly compared the efficacy of OW semaglutide 1 mg vs once-daily (OD) empagliflozin 25 mg in patients with T2D inadequately controlled on metformin monotherapy, using individual patient data (IPD) and meta-regression methodology. Design, Setting, Participants, and Interventions: IPD for patients with T2D receiving metformin monotherapy and randomized to OW semaglutide 1 mg (SUSTAIN 2, 3, 8 trials), or to OD empagliflozin 25 mg (PIONEER 2 trial) were included. Meta-regression analyses were adjusted for potential prognostic factors and effect modifiers. Main Outcome Measures: The primary efficacy outcomes were change from baseline to end-of-treatment (~1 year) in HbA1c (%-point) and body weight (kg). Responder outcomes and other clinically relevant efficacy measures were analyzed. Results: Baseline characteristics were similar between OW semaglutide (n = 995) and empagliflozin (n = 410). Our analyses showed that OW semaglutide significantly reduced mean HbA1c and body weight vs empagliflozin (estimated treatment difference: −0.61%-point [95% confidence interval (CI): −0.72; −0.49] and −1.65 kg [95% CI: −2.22; −1.08], respectively; both P < 0.0001). Complementary analyses supported the robustness of these results. A significantly greater proportion of patients on OW semaglutide vs empagliflozin also achieved HbA1c targets and weight-loss responses. Conclusions: This indirect comparison suggests that OW semaglutide 1 mg provides superior reductions in HbA1c and body weight vs OD empagliflozin 25 mg in patients withT2D when added to metformin monotherapy.
AB - Context: No head-to-head trials have directly compared once-weekly (OW) semaglutide, a human glucagon-like peptide-1 analog, with empagliflozin, a sodium–glucose co-transporter-2 inhibitor, in type 2 diabetes (T2D). Objective: We indirectly compared the efficacy of OW semaglutide 1 mg vs once-daily (OD) empagliflozin 25 mg in patients with T2D inadequately controlled on metformin monotherapy, using individual patient data (IPD) and meta-regression methodology. Design, Setting, Participants, and Interventions: IPD for patients with T2D receiving metformin monotherapy and randomized to OW semaglutide 1 mg (SUSTAIN 2, 3, 8 trials), or to OD empagliflozin 25 mg (PIONEER 2 trial) were included. Meta-regression analyses were adjusted for potential prognostic factors and effect modifiers. Main Outcome Measures: The primary efficacy outcomes were change from baseline to end-of-treatment (~1 year) in HbA1c (%-point) and body weight (kg). Responder outcomes and other clinically relevant efficacy measures were analyzed. Results: Baseline characteristics were similar between OW semaglutide (n = 995) and empagliflozin (n = 410). Our analyses showed that OW semaglutide significantly reduced mean HbA1c and body weight vs empagliflozin (estimated treatment difference: −0.61%-point [95% confidence interval (CI): −0.72; −0.49] and −1.65 kg [95% CI: −2.22; −1.08], respectively; both P < 0.0001). Complementary analyses supported the robustness of these results. A significantly greater proportion of patients on OW semaglutide vs empagliflozin also achieved HbA1c targets and weight-loss responses. Conclusions: This indirect comparison suggests that OW semaglutide 1 mg provides superior reductions in HbA1c and body weight vs OD empagliflozin 25 mg in patients withT2D when added to metformin monotherapy.
KW - GLP-1 receptor agonist
KW - Indirect comparison
KW - Individual patient data
KW - SGLT-2 inhibitor
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85092945387&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85092945387&partnerID=8YFLogxK
U2 - 10.1210/clinem/dgaa577
DO - 10.1210/clinem/dgaa577
M3 - Article
C2 - 32827435
AN - SCOPUS:85092945387
SN - 0021-972X
VL - 105
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 12
M1 - dgaa577
ER -