Efficacy and Safety of Once-Weekly Semaglutide Versus Once-Daily Sitagliptin as Metformin Add-on in a Korean Population with Type 2 Diabetes

Introduction Glucagon-like peptide-1 receptor agonists are well-established type 2 diabetes (T2D) treatments. As variations among populations and culture might influence treatment effects, this post hoc analysis evaluates the efficacy and safety of once-weekly (OW) semaglutide in a Korean population. Methods Korean adults with T2D inadequately controlled on metformin included in a 30-week, phase 3a, international, multicentre trial (NCT03061214) compared OW subcutaneous semaglutide (0.5 mg and 1.0 mg) with once-daily sitagliptin (100 mg). Key endpoints included change in glycated haemoglobin (HbA 1c ) and body weight; additional endpoints assessed proportions of participants reaching targets of HbA 1c < 7.0% and ≤ 6.5%, ≥ 5% weight loss, and a composite endpoint of HbA 1c < 7.0% without severe/blood glucose-confirmed symptomatic hypoglycaemia and no weight gain. Results Korean participants ( n = 110) showed a greater reduction in HbA 1c and body weight with semaglutide 0.5 mg (–1.6%, –2.7 kg) and 1.0 mg (–1.8%, –4.8 kg) versus sitagliptin (–0.9%, 0.5 kg). HbA 1c targets of < 7.0% and ≤ 6.5% were achieved by more participants treated with semaglutide 0.5 mg (80.0% and 60.0%, respectively) and 1.0 mg (87.5% and 67.5%, respectively) versus sitagliptin (54.3% and 25.7%, respectively); ≥ 5% weight loss was observed in 42.9% and 65.0% of participants treated with semaglutide 0.5 mg and 1.0 mg versus 0.0% with sitagliptin. The composite endpoint was achieved by 71.4%, 77.5%, and 31.4% of the population in the semaglutide 0.5 mg, 1.0 mg, and sitagliptin group, respectively. No new safety concerns were observed. Conclusion This analysis confirms efficacy and safety of OW semaglutide (0.5 and 1.0 mg) in a Korean population with T2D. Clinical Trial Registration Number NCT03061214.