Among patients with type 2 diabetes, the drug semaglutide taken by pill resulted in better glycemic control than placebo over 26 weeks, findings that support phase 3 studies to assess longer-term and clinical outcomes, as well as safety, according to a study published in JAMA.
The oral formulation of semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonists (a class of drugs used for the treatment of type 2 diabetes) may improve acceptance and adherence for some patients compared with the injectable formulation of GLP-1 receptor agonists, the study authors note.
In a phase 2 trial, Melanie Davies, MD, of the University of Leicester, United Kingdom, and colleagues randomly assigned 632 patients with type 2 diabetes and insufficient glycemic control to different doses and dose escalation of once-daily oral semaglutide; oral placebo; or once-weekly semaglutide by injection (subcutaneous) for 26 weeks.
The researchers found that average change in hemoglobin Alc (HbA1c) level from baseline to week 26 decreased with oral semaglutide (dosage-dependent range, -0.7% to -1.9%) and subcutaneous semaglutide (-1.9%) and placebo (-0.3%); oral semaglutide reductions were significant vs placebo. From an average baseline HbA1c level of 7.9%, between 44% (2.5-mg group) and 90% (40-mg standard escalation group) of patients receiving oral semaglutide achieved the target HbA1c level of less than 7%. Clinically relevant (5% or more) weight loss was achieved in up to 71% of patients receiving oral semaglutide. The adverse event profile of oral semaglutide was comparable with subcutaneous semaglutide.
Several limitations of the study are noted in the article, including duration.