Semaglutide Achieves Better Metabolic and Weight Control than Other GLP-1 RA in Real Life after 12 Months of Follow-up

Background and Aims: Weekly sc Semaglutide (WS) has demonstrated safety and efficacy in type 2 diabetes mellitus (T2D) in an extensive clinical development program. The main objective of the study was to assess the change in HbA1c and weight loss greater than 5% after 12 months of follow-up in real life. Materials and Methods: Retrospective observational study. Inclusion criteria:patients ≥ 18 years of age with T2D, eGFR ≥ 15 ml/min/1.73 m2 treated with WS. Main outcome variable: change in HbA1c (%) and weight ≥ 5% (kg). Secondary outcome variables: adverse events, withdrawal. Statistics: descriptive, student’s t, McNemar, multivariate logistic regression; SPSS vs. 19.0. Results: 247 patients, 55.4% men, age 62.8 ± 11.20 years, T2D evolution 10.4 ± 7.9 years; 14% smokers, 42.5% ex-smokers; 58% macroangiopathy, 54% microangiopathy; BMI 36.47 ± 6 Kg/m2; HbA1c 7.53 ± 1.4%; eGFR < 60 ml/min/1,73m2 46.5% and MAU > 30 mg/g 29.6%. In their baseline therapy, 55.9% used a GLP1 aR, (Liraglutide 66.7%, Dulaglutide 29.7%, ExenatideLAR 3.6%) and 44.8% insulin therapy. WS was suspended in 6.9% (44% digestive intolerance). 6.1% of patients on insulin had mild hypoglycemia. Overall, change in HbA1c -0.84 ± 1.1% (p <0.0001), change in weight -8 ± 16.6 kg (p <0.0001), weight change ≥ 5% 64.5%. The best compliance on weight change in people over 65 years of age with an OR 1.8 (95% CI: 1.02-3.17). Subpopulations analysis showed a change in HbA1c of -1.1 ± 1.2% (GLP1 aR naive) vs. -0.6 ± 1.9% (GLP1 aR prior-switch) (p 0.0001); weight change ≥ 5% -9.3 ± 6.4 Kg (GLP1aR naive) vs. -6.5 ± 6.7 Kg (GLP1 aR prior - switch) (p 0.0001). Significantly improved TAS (-7.5 ± 12.7 mmHg, p <0.0005), TAD (5.5 ± 9.4 p <0.0005), LDL -13.7 ± 30.11 mg/dl, p <0.0005, MALB 83.2 ± 432.4 mg/g, p <0.001. Conclusions: In real clinical practice, WS leads to an improvement in metabolic control and weight, both in patients T2D naïve to GLP1 aR (greater benefit), and in T2D patients previously treated with a different GLP1 aR, after one year. Disclosure M. Garcia de lucas: Advisory Panel; Spouse/Partner; Boehringer Ingelheim International GmbH, Novo Nordisk Inc., Speaker’s Bureau; Spouse/Partner; AstraZeneca, Lilly Diabetes, Sanofi. L. Pérez-belmonte: None. B. Aviles: None. A. Jimenez: None. J. Fernandez: None. F. Rivas ruiz: None.