Semaglutide as a therapeutic option for elderly patients with type 2 diabetes: Pooled analysis of the SUSTAIN 1-5 trials

Abstract

The efficacy and safety of semaglutide vs comparators in non-elderly (<65 years) and elderly (≥65 years) patients with type 2 diabetes (T2D) across the SUSTAIN 1-5 trials were evaluated. Patients were randomized to once-weekly subcutaneous semaglutide (0.5 or 1.0 mg) vs placebo, sitagliptin, exenatide or insulin. The primary objective was change in HbA1c and secondary objectives were changes in body weight and safety. Mean HbA1c decreased from baseline by 1.2%-1.5% and 1.5%-1.9% vs 0%-0.9% (non-elderly, n = 3045) and by 1.3%-1.5% and 1.2%-1.8% vs 0.2%-1.0% (elderly, n = 854) with semaglutide 0.5 and 1.0 mg vs comparators. Similar reductions from baseline in mean body weight with semaglutide occurred in both age groups. Similar proportions of patients experienced adverse events; premature treatment discontinuations were higher in elderly vs non-elderly patients. No increased risk of severe or blood glucose-confirmed hypoglycaemia was seen with semaglutide vs comparators between age groups. Semaglutide had a comparable efficacy and safety profile in non-elderly and elderly patients across the SUSTAIN 1-5 trials, making it an effective treatment option for elderly patients with T2D.

Keywords: GLP-1 analogue; antidiabetic drug; glycaemic control; incretin therapy; type 2 diabetes.

Figure 1

Change from baseline to end of treatment in HbA1c (A) and BW (B) by age group in SUSTAIN 1‐5. Abbreviations: BW, body weight; exenatide ER, exenatide extended release; IGlar, insulin glargine. In part A, all tests for treatment by subgroup interaction (<65/≥65 years) were non‐significant (except for SUSTAIN 4) between patients treated with semaglutide 1.0 mg and IGlar (P < 0.02). In part B, all tests for treatment by subgroup interaction (<65/≥65 years) were non‐significant. Non‐elderly: <65 years; elderly: ≥65 years