Efficacy and safety of semaglutide in type 2 diabetes compared with sitagliptin, exenatide ER, insulin glargine, basal insulin and placebo: A systematic review

Abstract

© 2017. Type 2 diabetes mellitus (T2DM) is a worldwide metabolic disorder associated with various complications. Despite available treatments for T2DM, there is still a significant unmet medical requirement. Recently, there is a new anti-diabetic drug namely once-weekly glucagon-like peptide 1 receptor agonist (GLP-1 RA), for example, semaglutide and duraglutide. This article will discuss the drug, semaglutide, in term of efficacy and safety. The purpose of this paper was to review efficacy and safety profiles of semaglutide. The relevant English-language articles were identified from PubMed, Web of Science, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, American Diabetes Association (ADA) meeting and European Association for the Study of Diabetes (EASD) meeting. Search items were semaglutide, diabetes mellitus [MeSH], glucose-like peptide 1 receptor agonists. Randomized controlled trials (RCTs) contain efficacy parameters (glycosylated hemoglobin [HbA1c, A1C], fasting plasma glucose [FPG], body weight [BW]) and safety parameters (incidence of hypoglycemia, retinopathy, nausea) were selected. Seven phase 3 RCTs were included. Semaglutide provided superior glycemic control compared with other glucose lowering drugs, supported by higher mean reduction of HbA1c, FPG and BW. Incidence of blood-confirmed or severe hypoglycemia of semalgutide was lower than others. However, incidence of nausea in semaglutide treatment was more than other comparators. In addition, incidence of diabetic retinopathy of semaglutide was similar to sitagliptin and insulin glargine, but more than placebo. Compared with other glucose lowering medications, semaglutide showed promising results in term of the reduction of HbA1c, BW, FPG, lower incidence of hypoglycemia, and comparable incidence of nausea and diabetic retinopathy.