The efficacy and safety of oral semaglutide for glycaemic management in adults with type 2 diabetes compared to subcutaneous semaglutide, placebo, and other GLP-1 RA comparators: A systematic review and network meta-analysis

Alhindi, Yousef; Avery, Amanda

doi:10.1016/j.conctc.2022.100944

Cited by 18 publications

(15 citation statements)

References 57 publications

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“…In general, the incidence of adverse effects was comparable between oral semaglutide and placebo or active comparators across any patient subgroups. As predicted, gastrointestinal symptoms such as nausea, vomiting, dyspepsia or diarrhoea were the most commonly observed side effects and they occurred more common with oral semaglutide and were mild to moderate in severity and transient [2,7]. In the background medication subgroups, 3 -17% of patients experienced serious adverse events, and up to 17% of patients quit their prescribed medicine permanently [57].…”

Section: Safety and Tolerabilitymentioning

confidence: 60%

Untitled

2023

FARMACIA

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Co-existing diabetes and obesity, frequently described by the term "diabesity", is a major health problem associated with increased long-term complications and mortality. The management of "diabesity" could be challenging, because several antidiabetic drugs cause weight gain. Glucagon-like peptide receptor agonists (GLP-1 RAs) have been demonstrated to be effective agents for achieving glycaemic control in addition to reducing body weight in patients with type 2 diabetes. Oral semaglutide, the first oral formulation of a GLP-1 RA, is an important therapeutic option for individuals with a preference for oral therapy. This medication was created by co-formulating the semaglutide molecule with an absorption enhancer (SNAC) to overcome the difficulties of oral peptide administration. The introduction of an oral GLP-1 RA broadens the therapeutic choices for patients and represents an important milestone in the management of "diabesity". RezumatCoexistența obezității și a diabetului zaharat, descrise frecvent prin termenul "diabesity" sau "diabezitate", reprezintă o problemă majoră de sănătate asociată cu creșterea complicațiilor și a mortalității pe termen lung. Managementul "diabezității" ar putea fi o provocare, deoarece mai multe medicamente antidiabetice pot determina creștere în greutate. S-a demonstrat că agoniştii receptorilor glucagon-like peptide-1 (GLP-1 RA) sunt eficienți pentru obținerea controlului glicemic pe lângă reducerea greutății corporale în cazul pacienților cu diabet zaharat tip 2. Semaglutida orală, prima formularea orală a GLP-1 RA, este o opțiune terapeutică importantă pentru persoanele cu preferință pentru terapia orală. Acest medicament a fost creat prin co-formularea moleculei de semaglutidă cu un amplificator de absorbție (SNAC) pentru a depăși dificultățile administrării orale a peptidelor. Introducerea unui agonist de receptor GLP-1 cu administrare orală, lărgește opțiunile terapeutice pentru pacienți și reprezintă un medicament cheie în tratamentul "diabezității".

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Section: Safety and Tolerabilitymentioning

confidence: 60%

Untitled

2023

FARMACIA

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“…Alhindi and Avery recently reported the efficacy and safety of oral semaglutide compared to injection of semaglutide and the other injection of GLP-1RA comparators by network meta-analysis [28]. They showed that oral semaglutide was non-inferior to injection of semaglutide and superior to other comparators in regarding HbA1c and body weight.…”

Section: Discussionmentioning

confidence: 99%

Oral Semaglutide Induces Loss of Body Fat Mass Without Affecting Muscle Mass in Patients With Type 2 Diabetes

Uchiyama¹,

Sada²,

Mihara³

et al. 2023

J Clin Med Res

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Background: Excessive body fat may be a major cause of insulin resistance and diabetes. But body weight reduction by energy restriction may simultaneously reduce both fat and muscle. Skeletal muscle is an important organ for glucose metabolism regulation, and loss of muscle may deteriorate glucose metabolism. Therefore, it is preferable to predominantly reduce fat without significant loss of muscle with weight loss in patients with type 2 diabetes. Previously, the antidiabetic agent glucagon-like peptide-1 receptor agonists (GLP-1RAs) liraglutide and semaglutide given by injection were reported to decrease fat with less effect on muscle in diabetic patients. Recently oral semaglutide was developed and was reported to decrease body weight, but the effect on muscle has not been fully evaluated.Methods: This was a non-interventional retrospective longitudinal study. We evaluated the effect of 24-week treatment with oral semaglutide on body fat and muscle mass in 25 Japanese patients with type 2 diabetes. Laboratory examination and body composition test by bioelectrical impedance analysis (BIA) were performed at baseline, 12 weeks, and 24 weeks, and the effects on glycemic control and body composition were assessed.Results: Hemoglobin A1c significantly decreased at 12 weeks and further ameliorated at 24 weeks (8.7±0.87% at baseline; 7.6±1.00% at 12 weeks; 7.0±0.80% at 24 weeks; mean ± standard error (SE)). While body fat significantly decreased (28.3 ± 1.52 kg at baseline; 26.8 ± 1.59 kg at 12 weeks; 25.5 ± 1.57 kg at 24 weeks; mean ± SE), whole-body lean mass was not significantly changed (48.1 ± 1.92 kg at baseline; 47.7 ± 1.93 kg at 12 weeks; 47.6 ± 1.89 kg at 24 weeks; mean ± SE). Furthermore, the appendicular skeletal muscle index (SMI) defined as appendicular skeletal muscle mass (ASM)/height squared (units; kg/m 2 ) was also unchanged. Conclusion:The 24-week treatment with oral semaglutide ameliorated glycemic control with reduction of body fat but not muscle mass in Japanese patients with type 2 diabetes.

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“…Despite the fact that some meta-analyses have compared the efficacy of oral semaglutide versus other GLP-1 RA [4,5], no head-to-head comparisons between the approved higher doses of oral and subcutaneous semaglutide have been performed. In a phase 2, open-label, dosefinding trial exploring the efficacy of doses of 2.5/5/10/20/40 mg of once-daily oral semaglutide, no statistically significant differences were found between doses of 20/40 mg of oral semaglutide and subcutaneous semaglutide (1 mg) [6].…”

Section: Dear Editormentioning

confidence: 99%

Switching from subcutaneous to oral semaglutide in type 2 diabetes: A prospective study

Martínez‐Montoro,

Picón‐César,

Generoso‐Piñar

et al. 2023

J Intern Med

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The efficacy and safety of oral semaglutide for glycaemic management in adults with type 2 diabetes compared to subcutaneous semaglutide, placebo, and other GLP-1 RA comparators: A systematic review and network meta-analysis

Cited by 18 publications

References 57 publications

Untitled

Untitled

Oral Semaglutide Induces Loss of Body Fat Mass Without Affecting Muscle Mass in Patients With Type 2 Diabetes

Switching from subcutaneous to oral semaglutide in type 2 diabetes: A prospective study

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