There are no published head-to-head trials of once-weekly semaglutide 1 mg vs. once-daily empagliflozin 25 mg in type 2 diabetes (T2D). We indirectly compared the pooled semaglutide arms in SUSTAIN 2, 3 and 8 with the empagliflozin arm in PIONEER 2 using individual patient data, for those on metformin monotherapy. Although all trials had similar inclusion criteria and duration, meta-regression analyses adjusting for effect modifiers and prognostic factors further controlled for differences in design and population. Mean baseline characteristics were similar with semaglutide and empagliflozin (age: 56 vs. 58 years, diabetes duration: 7 vs. 8 years, BMI: 33 vs. 33 kg/m2, HbA1c: 8.2% vs. 8.1%, respectively). Semaglutide reduced mean HbA1c by -1.4 vs. -0.8%-point with empagliflozin (p<0.001), and body weight by -5.3 vs. -3.7 kg with empagliflozin (p<0.001, Table). Sensitivity analyses, which were performed to assess robustness of these findings, supported these results. A significantly greater proportion of patients on semaglutide vs. empagliflozin also achieved HbA1c targets and clinically relevant weight-loss targets (Table). In this indirect comparison, pooled semaglutide 1 mg provided significantly greater HbA1c reduction and body weight loss compared with empagliflozin 25 mg in patients with T2D on metformin monotherapy.
I. Lingvay: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk A/S, Sanofi, TARGET PharmaSolutions, Valeritas, Inc. Other Relationship; Self; Novo Nordisk A/S. A. Catarig: Employee; Self; Novo Nordisk A/S. Employee; Spouse/Partner; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. A. Sandberg: None. J. Lawson: Employee; Self; Novo Nordisk A/S. M. Capehorn: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk A/S. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S. Speaker’s Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk A/S. P. Johansen: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. R.D. Shaw: Consultant; Self; Novo Nordisk A/S. A. Paine: Consultant; Self; Novo Nordisk A/S.
Novo Nordisk A/S