In the SUSTAIN trial program, once-weekly (OW) semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA) approved for treatment of type 2 diabetes, significantly reduced HbA1c and body weight (BW) vs. all comparators, with a safety profile consistent with the GLP-1RA class. Patient factors (e.g., BMI) may impact therapeutic choices. This post-hoc analysis of SUSTAIN 1-5 and 7-10 evaluated change from baseline to end of treatment in HbA1c and BW with OW semaglutide vs. comparator by baseline BMI subgroup. On-treatment without rescue medication data were evaluated in the full analysis set. Mixed model for repeated measurements analyses evaluated interaction between treatment and BMI subgroup by trial. Overall, 572, 1,867, 2,103 and 2,217 subjects with BMI <25, ≥25-<30, ≥30-<35 and ≥35 kg/m2, respectively, were evaluated. Estimated treatment difference for change in HbA1c favored semaglutide vs. comparator in most subgroups, and for BW favored semaglutide vs. comparator in all subgroups (Table). In general, treatment-by-subgroup interactions were nonsignificant (p>0.05); however, BW reduction was greater with semaglutide 1.0 mg vs. insulin with increasing BMI (p=0.005).

In summary, semaglutide resulted in greater reductions in HbA1c and BW vs. comparators in SUSTAIN 1-5 and 7-10; this effect was generally observed across BMI subgroups.


V.R. Aroda: Consultant; Self; Duke, Novo Nordisk Inc., Sanofi. Employee; Spouse/Partner; Merck & Co., Inc. Research Support; Self; Applied Therapeutics, Fractyl Laboratories, Inc., Novo Nordisk Inc., Sanofi. Other Relationship; Self; IMNE, Medscape. O. Frenkel: Employee; Self; Novo Nordisk A/S, Roche Pharma. J.P. Frias: Consultant; Self; Eli Lilly and Company, Gilead Sciences, Inc., LifeScan, Inc., Novo Nordisk A/S, Sanofi. Research Support; Self; Allergan plc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb, Eli Lilly and Company, Intercept Pharmaceuticals, Inc., Madrigal Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk A/S, Pfizer Inc., Sanofi. Speaker’s Bureau; Self; Merck & Co., Inc., Sanofi. C. Hindsberger: Consultant; Self; Novo Nordisk A/S. S.H. Gylvin: Employee; Self; Novo Nordisk A/S. C. le Roux: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., GI Dynamics Inc., Herbalife International of America, Inc., Johnson & Johnson, Novo Nordisk A/S, Sanofi. Speaker’s Bureau; Self; Lilly Diabetes. Stock/Shareholder; Self; Keyron. S. Madsbad: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi-Aventis. Research Support; Self; Boehringer Ingelheim International GmbH, Novo Nordisk A/S. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk A/S.


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