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07-01-2021 | ADA 2021 | Conference coverage | News

Semaglutide 2.4 mg benefits linked to sex and weight loss

Eleanor McDermid

medwireNews: Further analyses from STEP 2 show improvements in multiple cardiometabolic risk markers with semaglutide versus placebo, and potentially greater weight loss in women than men.

The investigators revealed the results of their post-hoc findings across three presentations at the virtual ADA 81st Scientific Sessions.

STEP 2 involved 1210 participants with type 2 diabetes and overweight or obesity, who were randomly assigned to receive semaglutide 2.4 mg or 1.0 mg, or placebo, for 68 weeks. The previously reported primary findings showed markedly greater weight loss among people taking the higher versus the lower dose, along with a small additional reduction in glycated hemoglobin.

The latest analyses show that up to 79% of semaglutide-treated participants achieved a glycated hemoglobin (HbA1c) level below 7% (53 mmol/mol) and 26% achieved this in conjunction with at least 15% weight loss, compared with a corresponding 26% and 3% of the placebo group, and that this was accompanied by a marked reduction in use of oral antidiabetic medications.

There were also significant improvements versus placebo in fasting blood glucose (up to 37 mg/dL; 2 mmol/L), insulin sensitivity (up to 28%), and beta-cell function (up to 69%).

These metabolic improvements were associated with an improved cardiometabolic profile. Taking semaglutide versus placebo was associated with improvements including up to a 4.9 cm reduction in waist circumference, as well as up to a 6 percentage point reduction in fasting insulin, a 3.4 mmHg reduction in systolic blood pressure, a 14 percentage point reduction in triglyceride levels, and a 39 percentage point decrease in C-reactive protein levels.

Almost all of these improvements were dose dependent, and markedly greater in people who lost at least 10% of their bodyweight, irrespective of treatment allocation, than in those who lost less weight.

Finally, a look at the influence of baseline variables suggested that the weight loss effect of semaglutide versus placebo, after accounting for multiple baseline variables, was significantly greater in people with HbA1c lower than 8.5% than in those with higher levels, and in women versus men.

The effect of sex persisted after adjustment for additional potential confounders, with estimated treatment differences for semaglutide versus placebo of 8.8 kg in women and 6.0 kg in men.

Robert Kushner (Northwestern University, Chicago, Illinois, USA) presented the cardiometabolic outcomes, Leigh Perreault (University of Colorado Anschutz Medical Campus, Aurora, USA) the metabolic findings, and Ildiko Lingvay (University of Texas Southwestern Medical Center, Dallas, USA) the impact of baseline variables.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group

ADA Scientific Sessions; 25–29 June 2021 (Abstract 80-OR)
ADA Scientific Sessions; 25–29 June 2021 (Abstract 82-OR)
ADA Scientific Sessions; 25–29 June 2021 (Abstract 83-OR)

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