The SUSTAIN clinical development program assessed semaglutide once weekly, a glucagon-like peptide-1 (GLP-1) analog, across the continuum of type 2 diabetes (T2D) care, including in drug-naïve subjects and those on a background of oral antidiabetic drugs and/or insulin. Semaglutide demonstrated superior reductions in HbA1c and body weight (BW) vs. placebo and comparators (sitagliptin, exenatide extended release, insulin glargine, dulaglutide). This post hoc analysis assessed the proportion of semaglutide-treated subjects achieving clinically relevant responses (composite endpoint: ≥1% HbA1c reduction and ≥5% BW loss; individual components: ≥1% HbA1c or ≥5% BW loss) by baseline HbA1c and BW across SUSTAIN 1-5 and 7. A consistently high proportion of semaglutide-treated subjects achieved clinically relevant responses (composite, 42.0%; ≥1% HbA1c reduction, 76.6%; ≥5% BW loss, 49.9%), regardless of baseline HbA1c and BW (Figure). Baseline HbA1c and BW did not affect the likelihood of achieving the composite and ≥5% BW endpoints. A ≥1% HbA1c reduction was significantly more likely to be achieved with higher baseline HbA1c (143% increased odds per 1% unit higher baseline HbA1c;p<0.0001). Semaglutide provides meaningful reductions in HbA1c and BW across a range of HbA1c and BW. Individuals with poorly controlled HbA1c were more likely to achieve a ≥1% HbA1c reduction.


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. J.F. Larsen: Employee; Self; Novo Nordisk A/S. S.H. Østoft: Employee; Self; Novo Nordisk A/S. R.R. Rea: Other Relationship; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk A/S, Sanofi. D. Sugimoto: Research Support; Self; Gan & Lee Pharmaceuticals, Novo Nordisk A/S, Sanofi. U. Ziegler: Employee; Self; KOEHLER eClinical GmbH, Freiburg im Breisgau, Germany. T. Vilsbøll: None.


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