Oral Semaglutide, A New Option in the Management of Type 2 Diabetes Mellitus: A Narrative Review
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REVIEW
Oral Semaglutide, A New Option in the Management of Type 2 Diabetes Mellitus: A Narrative Review Areti Sofogianni . Konstantinos Tziomalos
Received: July 1, 2020 Ó The Author(s) 2020
ABSTRACT According to current guidelines, glucagon-like peptide-1 (GLP-1) receptor agonists are the antidiabetic agent of choice in patients with type 2 diabetes mellitus (T2DM) and established cardiovascular disease (CVD) and are also the preferable antidiabetic agent in patients with T2DM without CVD but with indicators of high cardiovascular risk. A limitation in the use of GLP-1 receptor agonists is that they are delivered by subcutaneous injections. In this context, the development of an orally administered formulation of semaglutide offers an additional option in the management of patients with T2DM. In the present review, we discuss the findings of the main trials that evaluated the safety and efficacy of oral semaglutide. Oral semaglutide appears to be more effective in reducing HbA1c levels and body weight than other antidiabetic agents and similarly effective to other GLP-1 receptor agonists. The safety profile of oral semaglutide is also comparable with other members of its class. Even though oral semaglutide did not reduce the incidence of Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12800660. A. Sofogianni K. Tziomalos (&) First Propedeutic Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece e-mail: [email protected]
the composite primary endpoint in a randomized controlled trial, a reduction in cardiovascular and all-cause mortality was observed. Therefore, oral semaglutide appears to represent a useful tool in the management of patients with TD2M, particularly those with established CVD or high cardiovascular risk and unwilling to receive injectable GLP-1 receptor agonists.
Keywords: Cardiovascular disease; Glucagonlike peptide-1 receptor agonists; Oral semaglutide; Type 2 diabetes mellitus; Weight Key Summary Points Oral semaglutide reduces HbA1c and body weight more than other oral antidiabetic agents Oral semaglutide induces comparable reductions in HbA1c and body weight with injectable glucagon-like peptide-1 receptor agonists The safety profile of oral semaglutide is also similar with injectable glucagon-like peptide-1 receptor agonists
Adv Ther
INTRODUCTION According to current guidelines, glucagon-like peptide-1 (GLP-1) receptor agonists are the antidiabetic agent of choice in patients with type 2 diabetes mellitus (T2DM) and established cardiovascular disease (CVD) [1]. Moreover, GLP-1 receptor agonists are also the preferable antidiabetic agent in patients with T2DM without CVD but with indicators of high cardiovascular risk, including age C 55 years, coronary, carotid or lower extremity artery stenosis [ 50%, left ventricular hypertrophy, estimated glomerular filtration rate (GFR) \ 60 ml/min/1.73m2 or albuminuria [1]. Notably, these agents should be considered inde
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