Semaglutide Across Race and Ethnicity Groups

Cyrus DeSouza, Bertrand Cariou, Satish Garg, Nanna Lausvig, Andrea Navarria, Vivian Fonseca
The Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 2, February 2020, dgz072
https://doi.org/10.1210/clinem/dgz072

Abstract

Context

Variations in the prevalence and etiology of type 2 diabetes (T2D) across race and ethnicity may affect treatment responses. Semaglutide is a glucagon-like peptide-1 analog approved for once-weekly, subcutaneous treatment of T2D.

Objective

To compare semaglutide efficacy and safety in race and ethnicity subgroups across the SUSTAIN trials.

Design

Post hoc analysis of data from phase 3 randomized SUSTAIN 1–5 and 7 (pooled), and SUSTAIN 6 trials.

Participants

3074 subjects (SUSTAIN 1–5 and 7) and 1648 subjects (SUSTAIN 6).

Interventions

Semaglutide 0.5 or 1.0 mg, placebo, or active comparator (sitagliptin 100 mg, exenatide extended release 2.0 mg, insulin glargine 100IU/ml and dulaglutide 0.75 or 1.5 mg).

Main Outcome Measures

Change in hemoglobin A1C (HbA1c) and body weight from baseline to weeks 30, 40 and 104, and other efficacy and safety endpoints.

Results

HbA1c was reduced from baseline by 1.0 to 1.5 percentage points and 1.3 to 2.0 percentage points, and body weight was reduced by 2.3 to 4.7 kg and 3.6 to 6.1 kg with semaglutide 0.5 and 1.0 mg, respectively, across race and ethnicity subgroups. Minor changes in blood pressure and lipid profiles were observed. Adverse events (AEs) were reported in similar proportions of subjects across trials. More Asian versus other race subgroups discontinued treatment prematurely due to AEs. The most commonly reported AEs were gastrointestinal disorders.

Conclusions

In this SUSTAIN trials post hoc analysis, semaglutide was associated with consistent and clinically relevant reductions in HbA1c and body weight in subjects with T2D, with minor variations in efficacy and safety outcomes associated with race or ethnicity.

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