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Weight Loss With Semaglutide



sharma-obesity-insulin-injectionRegular readers will likely be aware of the recent approval of the GLP-1 analogue liraglutide as a once-daily injection for the treatment of obesity in the US, Canada, Europe and Mexico.

In the meantime, Novo Nordisk, the maker of liraglutide, is continuing its development of a new GLP-1 analogue semaglutide as a once-weekly injection for the treatment of diabetes and obesity.

Last week the company released topline data from its SUSTAIN 3 study, a phase 3a trial in around 800 patients with type 2 diabetes randomized (open-label) to once-weekly semaglutide 1.0 mg vs. exenatide 2.0 mg (another once weekly GLP-1 analogue) over 56 weeks.

Participants on semaglutide achieved a greater reduction in A1c (1.5% vs. 0.9%; baseline = 8.4%) and weight loss (5.6 kg vs. 1.8 kg; baseline = 96 kg) compared to exenatide.

In general, adverse events (mainly GI-symptoms) were as expected for GLP-1 analogues with a rate of nausea twice as high with semaglutide compared to eventide (22% vs. 11%).

The overall discontinuation rate due to adverse events was slightly higher with semaglutide than eventide but fairly low overall (9.4% vs. 7.2%).

It should be noted that this was a diabetes and not an obesity study – so the almost 6% weight loss is indeed quite impressive (weight loss in studies designed to test drugs for obesity tends to be higher as patients are also advises to change their diet and physical activity).

According to Novo Nordisk, phase 2 dose-ranging trials of semaglutide in obesity could begin as early as next year – certainly an interesting development to watch.

@DrSharma
Edmonton, AB

Disclaimer: I have received honoraria as a consultant and speaker from Novo Nordisk

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