Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1-3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10)

Aims. - SUSTAIN 10 compared the efficacy and safety of the anticipated most frequent semaglutide dose (1.0 mg) with the current most frequently prescribed liraglutide dose in Europe (1.2 mg), reflecting clinical practice. Methods. - In this phase 3b, open-label trial, 577 adults with type 2 diabetes (HbA(1c) 7.0-11.0%) on 1-3 oral antidiabetic drugs were randomized 1:1 to subcutaneous once-weekly semaglutide 1.0 mg or subcutaneous once-daily liraglutide 1.2 mg. Primary and confirmatory secondary endpoints were changes in HbA(1c) and body weight from baseline to week 30, respectively. Results. - Mean HbA(1c) (baseline 8.2%) decreased by 1.7% with semaglutide and 1.0% with liraglutide (estimated treatment difference [ETD] -0.69%; 95% confidence interval [CI] -0.82 to -0.56, P < 0.0001). Mean body weight (baseline 96.9 kg) decreased by 5.8 kg with semaglutide and 1.9 kg with liraglutide (ETD -3.83 kg; 95% CI -4.57 to -3.09, P < 0.0001). The proportions of subjects achieving glycaemic targets of < 7.0% and <= 6.5%, weight loss of >= 5% and >= 10%, and a composite endpoint of HbA(1c) < 7.0% without severe or blood glucose-confirmed symptomatic hypoglycaemia and no weight gain were greater with semaglutide vs liraglutide (all P < 0.0001). Both treatments had similar safety profiles, except for more frequent gastrointestinal disorders (the most common adverse events [AEs]) and AEs leading to premature treatment discontinuation with semaglutide vs liraglutide (43.9% vs 38.3% and 11.4% vs 6.6%, respectively). Conclusion. - Semaglutide was superior to liraglutide in reducing HbA(1c) and body weight. Safety profiles were generally similar, except for higher rates of gastrointestinal AEs with semaglutide vs liraglutide. (C) 2019 Elsevier Masson SAS. All rights reserved.