1000-P: Efficacy and Safety of Semaglutide 0.5 mg vs. Dulaglutide 1.5 mg Once Weekly in Type 2 Diabetes: A Post Hoc Analysis of SUSTAIN 7
Authors: PRATLEY RICHARD E. , ARODA VANITA R. , GONDOLF THEIS , HANSEN THOMAS , LINGVAY ILDIKO , LUEDEMANN JOERG , SKJOETH TRINE VANG , VILJOEN ADIE 
Published: June 2019

Semaglutide and dulaglutide are glucagon-like peptide-1 receptor agonists for the treatment of type 2 diabetes (T2D). In SUSTAIN 7, an international, open-label, parallel group trial, adults with inadequately controlled T2D were randomized (1:1:1:1) to once-weekly subcutaneous semaglutide or dulaglutide at low (0.5 vs. 0.75 mg) or high (1.0 vs. 1.5 mg) doses. Semaglutide provided superior glycemic control and reductions in body weight at both low and high doses. To study doses available in clinical practice, we performed a post hoc analysis of the effects of semaglutide low (0.5 mg) vs. dulaglutide high (1.5 mg) dose at week 40, using statistical methods in published prespecified analyses. Subjects mean age was 56 years, HbA1c 8.2%, diabetes duration 7.4 years; 77% were white. Efficacy data (Table) show similar glycemic control and blood pressure, and greater weight loss, for semaglutide 0.5 mg vs. dulaglutide 1.5 mg. Frequency and severity of adverse events (AEs) were similar for semaglutide and dulaglutide, including gastrointestinal (GI) AEs (nausea: 23% vs. 20%, respectively; vomiting: 10%, each treatment). Premature discontinuation due to GI AEs occurred in 5% of subjects in each arm.
In summary, semaglutide 0.5 mg showed similar improvements in glycemic control and greater weight loss vs. dulaglutide 1.5 mg at week 40, while showing similar tolerability in subjects with T2D.

Disclosure
R.E. Pratley: Consultant; Self; Sanofi US. Other Relationship; Self; AstraZeneca, Eli Lilly and Company, GlaxoSmithKline plc., Janssen Global Services, LLC., Janssen Research & Development, Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Mundipharma, Novo Nordisk Inc., Pfizer Inc., Sanofi, Takeda Development Center Americas, Inc. V.R. Aroda: Consultant; Self; ADOCIA, AstraZeneca, Becton, Dickinson and Company, Novo Nordisk Inc., Sanofi, Zafgen, Inc. Employee; Spouse/Partner; Merck & Co., Inc. Research Support; Self; AstraZeneca, Calibra Medical, Eisai Inc., Janssen Research & Development, Novo Nordisk Inc., Sanofi, Theracos, Inc. T. Gondolf: Employee; Spouse/Partner; Chr. Hansen Holding A/S. Employee; Self; Novo Nordisk A/S. T. Hansen: None. I. Lingvay: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Inc., MannKind Corporation. Consultant; Self; AstraZeneca, Novo Nordisk Inc., Sanofi, TARGET PharmaSolutions, Valeritas, Inc. Research Support; Self; Merck & Co., Inc., Mylan, Novo Nordisk Inc., Pfizer Inc. Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. J. Luedemann: None. T.V. Skjoeth: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. Stock/Shareholder; Spouse/Partner; Novo Nordisk A/S. A. Viljoen: Advisory Panel; Self; NAPP Pharmaceuticals Limited. Research Support; Self; Eli Lilly and Company, Sanofi-Aventis. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk A/S.

Funding
Novo Nordisk A/S