Comparing Once-Weekly Semaglutide vs Daily Empagliflozin in Type 2 Diabetics

While news surrounding SGLT2 inhibitors have dominated endocrinology for the last year, a new analysis suggests once-weekly semaglutide may be more effective than once-daily empagliflozin for reducing HbA1c and weight loss.

Presented at the American Diabetes Association's (ADA) 80th Scientific Sessions, results of the indirect comparison, which examined pooled data from clinical trials examining the agents, suggest once-weekly semaglutide may be more effective than empagliflozin in helping patients achieve HbA1c and weight loss goals.

“We’re able to draw some indirect conclusions comparing weekly semaglutide and once-daily, oral empagliflozin,” said Ildiko Lingvay, MD, professor of medicine at University of Texas Southwestern and medical director of the Office of Clinical Trials Management at UT Southwestern Medical Center, in a recent interview with HCPLive®.

With no head-to-head trials comparing the 2 agents, Lingvay and a team of colleagues sought to compare the 2 as add-on therapies to metformin using data from the SUSTAIN 2, 3, and 8 trials and the empagliflozin arm of PIONEER 2. Using data from these trials, investigators identified a group of 995 patients receiving 1 mg semaglutide and 410 receiving 25 mg empagliflozin.

Investigators highlighted baseline characteristics between these 2 groups were similar, with a mean age of 56 and 58 years, mean diabetes duration of 7 and 8 years, and HbA1c levels of 8.2% and 8.1%, respectively, for semaglutide and empagliflozin. Additionally, BMI for both groups was 33 kg/m2.

Semaglutide use was associated with a greater reduction in mean HbA1c versus empagliflozin with reductions of -1.4% and -0.8%, respectively (P <.001). Semaglutide was also associated with greater mean weight loss reductions, with patients receiving semaglutide losing a mean of 5.3 kg versus 3.7 kg with empagliflozin (P <.001). Additionally, results of a sensitivity analysis supported these findings.

Investigators also highlighted a greater proportion of patients receiving semaglutide were able to achieve weight loss and HbA1c targets than those receiving empagliflozin.

To learn more about this analysis, HCPLive invited Lingvay to take part in a special ADA 2020 House Call.

This study, “Once-Weekly Semaglutide 1mg vs. Empagliflozin 25mg as Add-On to Metformin Monotherapy in Patients with Type 2 Diabetes: A Meta-regression Analysis of Individual Patient Data,” was presented at ADA 2020.