Efficacy of semaglutide vs. dulaglutide across baseline HbA1c in SUSTAIN 7

Semaglutide a glucagon-like peptide-1 (GLP-1) analogue for the treatment of type 2 diabetes (T2D) showed significant and clinically meaningful HbA1c and body weight reductions across the SUSTAIN programme. This post hoc analysis of the phase 3b SUSTAIN 7 trial evaluated semaglutide 0.5 mg vs. dulaglutide 0.75 mg and semaglutide 1.0 mg vs. dulaglutide 1.5 mg by baseline HbA1c in subjects with T2D. Methods: Efficacy data from SUSTAIN 7 were evaluated; subjects were stratified by baseline HbA1c (≤7.5%, 7.5 – 8.0%, 8.0 – 8.5%, 8.5 – 9.0%, > 9.0%). For treatment target endpoints, missing data were imputed from a mixed model for repeated measurements. Results: At week 40, greater reductions in HbA1c were observed with semaglutide vs. dulaglutide across subgroups. Changes from BL in body weight favoured semaglutide 0.5 mg vs. dulaglutide 0.75 mg and semaglutide 1.0 mg vs. dulaglutide 1.5 mg; no significant interaction between treatment and BL HbA1c were observed. More subjects with BL HbA1c > 9% achieved HbA1c < 7% with semaglutide 0.5 mg vs. dulaglutide 0.75 mg (44 vs. 18%) and semaglutide 1.0 mg vs. dulaglutide 1.5 mg (55 vs. 34%). Similarly, more subjects with BL HbA1c > 9% achieved HbA1c ≤6.5% with semaglutide 0.5 mg vs. dulaglutide 0.75 mg (32 vs. 9%) and semaglutide 1.0 mg vs. dulaglutide 1.5 mg (41 vs. 20%). Conclusion: Greater reductions in HbA1c and body weight were observed with semaglutide vs. dulaglutide in all subjects regardless of BL HbA1c.