Comparing medication persistence with oral and subcutaneous semaglutide in a real-world setting.

IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Matteo Conti, Lorenzo Pontiggia, Michela Vergani, Emanuele Muraca, Rosa Cannistraci, Silvia Perra, Guido Lattuada, Gianluca Perseghin, Stefano Ciardullo
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Abstract

Aims: To compare medication persistence and efficacy of oral and subcutaneous semaglutide, in a real-world setting.

Materials and methods: This is a single-center, retrospective observational cohort study. Patients with type 2 diabetes mellitus (T2DM) starting treatment with either formulation of semaglutide between January 1 2019 and July 31 2023 and with at least one follow-up visit were included. The primary endpoint was the difference in the proportion of patients that continued treatment after 6, 12 and 18 months. Main secondary endpoints were change in HbA1c and body weight.

Results: We included 242 patients on oral (n = 121) and subcutaneous (n = 121) semaglutide. At baseline, patients in the oral semaglutide group were significantly older (mean age: 67 ± 11 vs. 63 ± 11 years, p = 0.002) and had a lower body mass index (BMI: 30.5 ± 5.6 vs. 33.9 ± 7.1 kg/m2, p < 0.001). The proportion of patients persistent to treatment was significantly lower in the oral group at 6 (85.3% vs. 94.8%; p < 0.001), 12 (72.3% vs. 92.4%, p < 0.001) and 18 (46.0% vs. 83.8%; p < 0.001) months. Most common reasons for discontinuation were gastro-intestinal side effects. When adjusted for age and BMI, body weight and HbA1c reduction were not significantly different between the two formulations, as the proportion of patients achieving the composite outcome of weight loss ≥ 5% and HbA1c < 7.0%.

Conclusions: The present real-world study suggests that persistence is significantly lower when semaglutide is administered as a once-daily tablet compared with a weekly injection, while there are no differences in efficacy between the two formulations.

目的:在现实世界中比较口服和皮下注射塞马鲁肽的用药持续性和疗效:这是一项单中心回顾性队列研究。研究纳入了在2019年1月1日至2023年7月31日期间开始接受任何一种塞马鲁肽制剂治疗且至少接受过一次随访的2型糖尿病(T2DM)患者。主要终点是6个月、12个月和18个月后继续治疗的患者比例差异。主要次要终点是 HbA1c 和体重的变化:我们纳入了 242 名口服(121 人)和皮下注射(121 人)塞马鲁肽的患者。基线时,口服塞马鲁肽组患者的年龄明显偏大(平均年龄:67 ± 11 岁 vs. 63 ± 11 岁,P = 0.002),体重指数较低(BMI:30.5 ± 5.6 vs. 33.9 ± 7.1 kg/m2,P 结论:本研究表明,口服塞马鲁肽组患者的 HbA1c 和体重发生了变化:本真实世界研究表明,与每周注射一次相比,每日一次片剂给药的塞马鲁肽的持续率明显较低,而两种制剂的疗效没有差异。
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来源期刊
Acta Diabetologica
Acta Diabetologica 医学-内分泌学与代谢
CiteScore
7.30
自引率
2.60%
发文量
180
审稿时长
2 months
期刊介绍: Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.
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